PubMed · 13985308
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P TOKER. Delayed postanoxic encephalopathy.. https://doi.org/10.1097/00000542-196305000-00022
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INTRODUCTION: 3-Tesla (T) magnetic resonance imaging (MRI) offers high resolution imaging with improved signal quality. It also allows for improved functional investigations, most prominently with respect to fiber tracts and their relation to pathological lesions. Up to now, patients with adjustable shunt systems were not eligible for high field power magnetic resonance imaging. We have evaluated the effects of this technique upon a newly developed adjustable shunt valve. METHOD: Ten adjustable shunt devices were examined during routine and functional 3-T high field MRI examinations. Pressure settings were checked after 17 examinations each for all valves. There were no changes in pressure setting at all possible levels in any of the tested devices. No problems with the adjusting mechanism were observed during 340 examinations. CONCLUSION: This new shunt device offers the diagnostic benefit of high field magnetic resonance imaging in shunt-dependent patients who need an adjustable valve. The valve is not affected by higher magnetic field power and does not require readjustment of the pressure settings after MRI examination.
The immunological mechanisms leading to tissue damage in inflammatory brain diseases are heterogeneous and complex. They may involve direct cytotoxicity of T lymphocytes, specific antibodies and activated effector cells, such as macrophages and microglia. Here we describe that in certain inflammatory brain lesions a pattern of tissue injury is present, which closely reflects that found in hypoxic conditions of the central nervous system. Certain inflammatory mediators, in particular reactive oxygen and nitrogen species, are able to mediate mitochondrial dysfunction, and we suggest that these inflammatory mediators, when excessively liberated, can result in a state of histotoxic hypoxia. This mechanism may play a major role in multiple sclerosis, not only explaining the lesions formed in a subtype of patients with acute and relapsing course, but also being involved in the formation of diffuse "neurodegenerative" lesions in chronic progressive forms of the disease.
Intraoperative high-field MRI with integrated microscope-based neuronavigation is a safe and reliable technique providing immediate intraoperative quality control. Major indications are pituitary tumor, glioma, and epilepsy surgery. Intraoperative high-field MRI provides intraoperative anatomic images at high quality that are up to the standard of pre- and postoperative neuroradiologic imaging. Compared with previous low-field MRI systems used for intraoperative imaging, not only is the image quality is clearly superior but the imaging spectrum is much wider and the intraoperative work flow is improved. Furthermore, high-field MRI offers various modalities beyond standard anatomic imaging, such as magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI.