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Biomedical subjects

D Reizine

Publications and source records attributed to D Reizine.

At least 19 recordsLinked to original sources
PubMed2006

Dilation of Virchow-Robin spaces in CADASIL.

To precise the severity of dilated Virchow-Robin spaces (VRS) in CADASIL patients and to determine their correlation with clinical presentation and other abnormalities on cerebral Magnetic Resonance Imaging (MRI). Dilated VRS were previously associated with aging, hypertension, dementia, epilepsy or migraine. We already reported increased frequency of enlarged VRS in CADASIL patients when compared with family members without the affected haplotype. We analysed clinical and MRI data from 50 CADASIL patients collected prospectively in our center. The presence of dilated VRS was assessed in the subcortical white matter of temporal lobes, the centrum semi-ovale and the basal ganglia. Their severity in each region was evaluated according to the scale proposed by Heier. We compared the clinical data, the severity of white matter abnormalities and the presence of microbleeds in patients with and without dilated VRS. Seventy-eight percent of patients in our series had dilated VRS, mostly located in the lentiform nuclei (94%) and subcortical white matter of the temporal lobes (66%). The severity of these lesions was variable but not correlated neither to the extent of white matter abnormalities nor to the clinical presentation in our patients. Only the age was found to be related to the extent of dilated VRS. Dilated VRS are frequent in CADASIL and mostly located in the temporal white matter and basal ganglia. The dilation of perivascular spaces does not seem to be directly related to the occurrence of ischemic or hemorrhagic lesions in CADASIL. In contrast, the relation with age suggests that either aging, progression of vascular wall alterations during the course of the disease, or both of these processes can favour the extension of VRS in CADASIL.

Adult↗
PubMed2005

Intra-arterial thrombus visualized on T2* gradient echo imaging in acute ischemic stroke.

BACKGROUND: MR signal loss related to arterial thrombosis leading to vascular susceptibility artifacts (VSA) has recently been reported on gradient echo images. The time course and sensitivity of VSA in acute stroke patients has been scarcely investigated. The aim of this study was to assess the frequency and course of VSA in acute stroke patients, to compare its sensitivity to distinct features of arterial occlusion as detected on FLAIR images or on CT scan. METHODS: Twenty-nine patients were scanned from 45 min to 6 h after stroke onset using identical MR parameters. All had an acute ischemic lesion identified on diffusion-weighted images, 25 had an occlusion of MCA or PCA confirmed by magnetic resonance angiography. RESULTS: VSA was detected in 22/25 patients having an occluded artery at the time of MRI examination. Flair disclosed a hyperintense vessel in all of these 25 cases, but CT scan revealed a hyperdense artery in only 15 cases. Follow-up studies showed that VSA can vanish or disappear after partial recanalization. When the artery remains occluded, VSA can decrease, disappear or increase in the next hours, possibly related to structural modifications of the thrombus with time. Most occlusions were due to cardiac and arterial emboli or to intracranial extension of carotid occlusion. CONCLUSIONS: VSA are frequent in the first hours of MCA or PCA occlusion in acute stroke patients. The sensitivity of VSA appears lower than the arterial hyperintensity on FLAIR images but higher than the hyperdense artery sign on CT scan. The extent and intensity of VSA can change with recanalization or structural modifications of the thrombus.

Adolescent↗
PubMed2004

[Rhinocerebral mucormycosis].

We report a case of a rhinocerebral mucormycosis with extensive cavernous sinus thrombophlebitis and internal carotid artery thrombosis. This case illustrates the usual clinical and imaging features of the disease, which is a potentially devastating infection in immunocompromised patients.

Carotid Artery Thrombosis↗
PubMed2001

[Study of the middle ear. Value of multiplanar reconstructions in spiral tomodensitometry].

We point out the interest of computed tomographic reconstructions from spiral acquisition--particularly sagittal reconstructions--in the study of middle ear anatomy and adjacent structures: the facial canal and the chorda tympani. The reference reconstructions are axial and coronal reconstructions. So, we demonstrate the superiority of sagittal reconstructions for the visualization of the lateral process of the malleus, the body and long process of the incus, the third portion of the facial canal, and the chorda tympani. For the other structures of the middle ear and the other parts of the facial canal, these sagittal reconstructions are complementary. Besides, the best type of reconstruction to visualize the stapes and the vestibular window is the axial plane parallel to the stapes axis.

Ear, Middle↗
PubMed2000

[Arteriovenous malformations: a study of 200 cases].

OBJECTIVE: The aim of this study was to analyze the natural history of arteriovenous malformations by reviewing 200 consecutive cases observed in all localizations between 1992 and 1996 in a multidisciplinary angioma clinic. PATIENTS AND METHODS: Files concerning 200 arteriovenous malformations were reviewed with a standardized observation sheet applying the severity criteria defined by the International Society for the Study of Vascular Anomalies. We used the Schobinger staging system which includes 4 grades of severity: grade I=dormancy, grade II=expansion, grade III=destruction, grade IV=cardiac decompensation. RESULTS: There was no predominance by gender. Cephalic localizations were the most common. The malformation was present at birth as indicated by history taking in 40 p. 100 of the cases. Progression during childhood (grade II) was observed in 84 p. 100. At the first consultation, the patients generally were more often in grade II than in grade I or III. Bone destruction was observed in 3 cases, signs of cardiac decompensation in 5. Arteriovenous malformations were part of a more complex syndrome in 9 cases. We noted a flare-up in the prepuberty or puberty period in 75 p. 100 of the cases and the possible role of puberty (64 cases), trauma (39 cases) and pregnancy (25 p. 100 of the adult women). Explorations were generally completed (Doppler, arteriography) by grade II, expressing the need for a map of expanding lesions. Finally it was difficult to assess posteriorly the beneficial or deleterious effect of the often multiple treatments prescribed for these patients. DISCUSSION: The review of these 200 cases pointed out the "pediatric" nature of the problem of arteriovenous malformations in the large majority of the cases and the often misleading presentation of these vascular anomalies, particularly grade I malformations. A false aspect of capillary malformation could raise the risk of inappropriate treatment. This review also confirmed known factors of exacerbation (puberty, pregnancy, trauma) and demonstrated the severity of these vascular anomalies which can progress with loco-regional expansion and invasion without a cellular proliferation component. The analysis of treatments used showed that embolization alone cannot definitively and totally control a superficial arteriovenous malformation and that no one treatment, even combined embolization and large excision, can be a guarantee to provide total cure.

Adolescent↗
PubMed1999

Deep cerebral venous thrombosis: imaging in eight cases.

Deep cerebral venous thrombosis (DCVT) is a rare, potentially fatal disease. We carried out a retrospective analysis of eight patients presenting with DCVT, using CT and MRI data. Digital subtraction angiography (DSA), MR angiography (MRA) (2D phase-contrast), and angiography were performed in four, four and two patients, respectively. Direct (venous abnormalities) and indirect (parenchymatous involvement) signs of thrombosis were assessed. Follow-up MRI and MRA were performed on two patients. CT was initially normal in two patients, demonstrated a "cord sign" in deep veins in five and deep venous infarcts in three. When performed within a week of admission (seven patients), MRI showed thrombosis as into intense or high signal in deep veins on sagittal T1-weighted spin-echo images in all patients, and on axial T2-weighted spin-echo images in two. Deep venous infarcts were found in five patients. Direct or indirect signs of sagittal or lateral sinus thrombosis were present on CT in two patients and on MRI in five. CT angiography, MRA and DSA were concordant with MRI findings. CT venography showed persistent flow in thrombosed veins. MRI follow-up demonstrated progressive deep venous recanalisation.

Adolescent↗
PubMed1999

[Tuberculosis of the central nervous system. MRI features and clinical course in 12 cases].

OBJECTIVE: The aim of this study was to characterize the MR findings of various intracranial lesions in the central nervous system (CNS) tuberculosis. MATERIALS AND METHODS: The MRI findings (T1, T2 and T1 sequence after contrast) of 12 proved cases (10 males, 2 females, 24 to 64 years old, average: 35) of CNS tuberculosis were reviewed; 4 patients were seropositive for HIV. RESULTS: Several types of lesions were identified: tuberculomas called miliary lesions if they were smaller than 2 mm in diameter (7 cases), in 1 case the tuberculoma was revealed by two large lesions and bi-hemispheric localisations, leptomeningitis (5 cases), infarction (4 cases), abscesses (3 cases with solitary lesions in 2/3 cases), hydrocephalus (3 cases), pachymeningitis (2 cases). A tuberculomas-leptomeningitis association was found in 4 patients. The pachymeningitis form had an unusual aspect in one case. Patients with leptomeningitis showed thick meningeal contrast enhancement involving all basal cisterns, expanding to the sylvian fissures level, and causing narrowing of the sylvian arteries. Massive infarctions resulted from arterial englobement or embols. In three out of five patients, leptomeningitis was the initial presentation. In seropositive patients, tuberculosis was severe with high mortality (3/4 patients), and associated with other multiple lesions. CONCLUSION: Central nervous system tuberculosis has different appearances, mostly tuberculomas and leptomeningitis. MR with contrast is necessary for follow-up during treatment.

Adult↗
PubMed1999

Spinal vascular malformations: endovascular therapy

Over the past 30 years, the development of diagnostic spinal angiography has led to effective endovascular techniques for treatment of spinal vascular malformations. Specific locations, size, rapidity of shunt, and clinical presentation determine the best treatment and prognosis.

Journal Article↗
PubMed1998

Internal carotid artery dissection causes hypoglossal nerve palsy: CT, MRI, and angiographic findings.

A case of unilateral XIIth nerve palsy due to the dissection of the internal carotid artery is reported. The clinical and radiological features are described. In this patient, cranial nerve palsy is probably the result of compression by an enlarging carotid artery due to mural hematoma. Diagnosis is discussed with emphasis on magnetic resonance imaging findings. Magnetic resonance imaging is also useful for follow-up of arterial lesions.

Adult↗
PubMed1997

MRI and MRA for diagnosis and follow-up of cerebral venous thrombosis (CVT).

OBJECTIVE: To assess the sensitivity of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in the diagnosis and the follow-up of cerebral venous thrombosis (CVT). To describe MRI and MRA features in CVT. MATERIAL AND METHODS: The clinical and neuroradiological studies of 20 patients with proven CVT were reviewed. All patients underwent computed tomography (CT), MRI (with MRA for 15 patients) and digital substraction angiography (DSA). Eleven patients had follow-up after treatment with MRI (nine with MRA). RESULTS: MRI and MRA together provided the diagnosis of CVT in all cases. The sensitivity of MRI alone was 90%. MRA showed abnormalities in all cases of CVT. Progressive sinus recanalization was demonstrated by follow-up with MRI and MRA at least 15 days after diagnosis and treatment. CONCLUSION: In most of cases, the combination of MRI and MRA is sufficient to allow diagnosis of CVT and obviates the need for invasive angiography. MR studies are also useful for the follow-up of CVT.

Adolescent↗
PubMed1996

Cerebral developmental venous anomalies associated with head and neck venous malformations.

PURPOSE: To study cerebral developmental venous anomalies in patients with extensive venous malformations of the head and neck. METHODS: All patients had undergone carotid angiography 10 to 15 years previously. Four-vessel cerebral angiography was carried out in 40 patients with venous malformations. All patients had a physical examination, 16 had CT, and 22 were examined with MR imaging. One patient had MR angiography. RESULTS: Eighteen developmental venous anomalies were noted in 8 (20%) of 40 patients. Four patients had multiple anomalies, and these were bilateral in 1 patient. Developmental venous anomalies seen in association with cervicofacial, cutaneous, and mucosal venous malformations were remarkable in their absence of neurologic events and associated cavernoma; significance of ectatic venous convergence, extension, and preponderance of deep drainage routes; and frequency with which they multiple in occurrence. CONCLUSION: Developmental venous anomalies have a remarkable prevalence of 20% in patients with extensive superficial venous malformations. Therefore, it is important to search for a cerebral developmental venous anomaly when confronted with a cervicofacial venous malformation.

Adolescent↗
PubMed1995

Percutaneous transcatheter embolization in multiply injured patients with pelvic ring disruption associated with severe haemorrhage and coagulopathy.

Six multiply injured patients with pelvic fractures were treated by percutaneous transcatheter embolization during a 10 month period. Diagnosis and therapy were carried out early in two cases (first day of admission into the trauma unit). Three patients were treated on the second day after admission. The last patient was embolized on the third day. Two patients underwent one and two remote embolizations. Embolization was indicated due to uncontrolled haemorrhaging, requiring large volumes of packed erythrocytes (median: 11.3) and fresh frozen plasma units (median: 6.8). Three patients had severe coagulopathy (disseminated intravascular coagulation). From two to 12 arteries were embolized per patient (median: 5). After successful transcatheter embolization, the circulation and coagulation stabilized rapidly without recurrence of haemorrhage or coagulopathy.

Adult↗
PubMed1994

Spinal epidural haematoma: report of 11 cases and review of the literature.

Spinal epidural haematomas (SEH) are rare; most are caused by trauma, anticoagulant therapy, vascular anomalies, hypertension, blood dyscrasias, epidural anaesthesia or, rarely, spinal surgery. We report 11 cases and review the literature (16 cases). The clinical picture is that of acute spinal cord compression. MRI characteristics are quite specific. On sagittal sections, the SEH appears as a biconvex mass, dorsal to the thecal sac, clearly outlined and with tapering superior and inferior margins. The dura mater is seen as curvilinear low signal separating the haematoma from the cord. Within 24 h of onset, the haematoma is isointense with the cord on T1-weighted images and heterogeneous on T2-weighted images. Later, it gives high signal on both T1- and T2-weighted images. Differential diagnosis must include subdural haematoma, epidural neoplasm and abscess. Complete neurological recovery rapidly follows laminectomy and removal of the clot. In three of our cases, the haematoma resolved spontaneously. MRI is the best examination for diagnostic and follow-up.

Adult↗
PubMed1994

Vertebral arteriovenous fistulas: a study of 49 cases and review of the literature.

The experience is reported with 50 vertebral fistulas treated by the authors in a joint radiological and surgical team. Of the 28 fistulas that were traumatic, 18 occurred after incidental iatrogenic puncture, and 22 were spontaneous, of which four presented in patients displaying angiographic features of fibromuscular dysplasia. Eleven patients were operated on and 33 had endovascular treatment. In nine patients who were either symptom-free or in poor health, no treatment was advised. The fistula was occluded in 38 (93%) of the treated patients, and the vertebral artery patency was preserved in 32 (78%). A total of 224 published cases were reviewed: 152 were traumatic, most after a penetrating injury; 72 were spontaneous, with three age peaks (at 7, 26 and 52 years). Treatment has evolved considerably and endovascular occlusion is now the treatment of choice, surgery being reserved for specific indications.

Adolescent↗
PubMed1994

Spinal vascular malformations: endovascular therapy.

Over the past 30 years, the development of diagnostic spinal angiography has led to effective endovascular techniques for treatment of spinal vascular malformations. Specific location, size, rapidity of shunt, and clinical presentation determine the best treatment and prognosis.

Arteriovenous Malformations↗
PubMed1993

Pyogenic parenchymatous and nidus infection after embolization of an arteriovenous malformation. An unusual complication. Case report.

Infectious complications of cerebral angiography and of therapeutic angiographic procedures are very seldom reported. The case of an infected embolized arteriovenous malformation (AVM) by staphylococcus aureus is reported. Abscess formation became manifest seven months after the endovascular procedures. Antibiotherapy was initially started after puncturing the abscess, but finally the cure of the lesion could only be obtained by radical excision of the infected and embolized AVM, as if the persisting embolization material was promoting the infection. The modalities of infection after cerebral endovascular procedures are discussed.

Adult↗
PubMed1993

Phase contrast magnetic resonance of the spinal cord preliminary results in spinal cord arterio-venous malformations.

In spite of the recent advances in neuroradiology including the CT scan and the spin-echo-magnetic resonance (MR), accurate diagnosis of arteriovenous malformations (AVMs) involving the spinal cord is still based on selective angiography. This last procedure is invasive and needs to be repeated during the follow up. Phase contrast angio MR was performed with a 0.5 Tesla unit on 12 patients with an AVM involving the spinal cord (7 intramedullary AVMs, 4 perimedullary fistulas, and 1 dural fistula with perimedullary venous drainage); 4 of these were investigated before and after treatment. Angio MR showed abnormal vascular patterns within the spinal canal in all cases, without distinguishing between arteries and veins; the nidus of the intramedullary AVMs was displayed in all cases. Angio MR provided images of the whole AVMs comparable to the angiographic pictures, in contrast to the spin-echo MR, which provided only discontinued images of the vessels. The efficient range of velocity providing images varied, according to the type of the malformation (slow for dural fistulas, rapid for intra-medullary AVMs). In the 4 patients investigated after treatment, comparison of the images obtained before and after treatment permitted assessment of the degree of occlusion of the malformation. Finally, angio MR as a complement of spin-echo MR can now be used as a reliable tool for detection of spinal cord AVMs, assessing the indication for angiography, and, furthermore, it can probably replace most of the post-operative control angiographies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗