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AJNR. American Journal of Neuroradiology Nov 2017Measuring the volume of fetal brain structures is challenging due to fetal motion, low resolution, and artifacts caused by maternal tissue. Our aim was to introduce a...
BACKGROUND AND PURPOSE
Measuring the volume of fetal brain structures is challenging due to fetal motion, low resolution, and artifacts caused by maternal tissue. Our aim was to introduce a new, simple, Matlab-based semiautomated method to measure the volume of structures in the fetal brain and present normal volumetric curves of the structures measured.
MATERIALS AND METHODS
The volume of the supratentorial brain, left and right hemispheres, cerebellum, and left and right eyeballs was measured retrospectively by the new semiautomated method in MR imaging examinations of 94 healthy fetuses. Four volume ratios were calculated. Interobserver agreement was calculated with the intraclass correlation coefficient, and a Bland-Altman plot was drawn for comparison of manual and semiautomated method measurements of the supratentorial brain.
RESULTS
We present normal volumetric curves and normal percentile values of the structures measured according to gestational age and of the ratios between the cerebellum and the supratentorial brain volume and the total eyeball and the supratentorial brain volume. Interobserver agreement was good or excellent for all structures measured. The Bland-Altman plot between manual and semiautomated measurements showed a maximal relative difference of 7.84%.
CONCLUSIONS
We present a technologically simple, reproducible method that can be applied prospectively and retrospectively on any MR imaging protocol, and we present normal volumetric curves measured. The method shows results like manual measurements while being less time-consuming and user-dependent. By applying this method on different cranial and extracranial structures, anatomic and pathologic, we believe that fetal volumetry can turn from a research tool into a practical clinical one.
Topics: Brain; Female; Fetus; Gestational Age; Humans; Magnetic Resonance Imaging; Male; Neuroimaging; Reproducibility of Results; Retrospective Studies
PubMed: 28838909
DOI: 10.3174/ajnr.A5349 -
Neuropathology of central nervous system arterial syndromes. Part I: the supratentorial circulation.Journal of Neuropathology and... Feb 2009The objective of this review is to illustrate the principal cerebrovascular arterial pathoanatomical syndromes using the unique collection of whole brain sections in the... (Review)
Review
The objective of this review is to illustrate the principal cerebrovascular arterial pathoanatomical syndromes using the unique collection of whole brain sections in the Raymond Escourolle Neuropathology Laboratory at Salpêtrière in Paris. The arterial supratentorial syndromes are presented in Part I; the infratentorial and spinal cord syndromes will be presented subsequently in Part II. No attempt is made to be all-inclusive in the review of the literature; rather, we cite only those bibliographic references that are historically noteworthy and with some exceptions that particularly emphasize the neuropathologic rather than radiographic/imaging aspects of the vascular syndromes. From these studies and our own archival material, we have synthesized the salient clinicopathologic aspects of the individual syndromes.
Topics: Brain; Brain Infarction; Cerebral Arteries; Cerebrovascular Circulation; Circle of Willis; Diencephalon; Humans; Intracranial Arterial Diseases; Syndrome
PubMed: 19151625
DOI: 10.1097/NEN.0b013e3181966c45 -
Journal of Clinical Neuroscience :... May 2010Neurenteric cysts are rare congenital, benign, endodermal lesions of the central nervous system that occur mainly in the spinal canal. Intracranial neurenteric cysts are...
Neurenteric cysts are rare congenital, benign, endodermal lesions of the central nervous system that occur mainly in the spinal canal. Intracranial neurenteric cysts are rare; the posterior fossa being the most common site. A laterally based supratentorial neurenteric cyst is exceptionally uncommon. The rarity of supratentorial neurenteric cysts and their variable imaging features preclude preoperative diagnosis. A search of the literature revealed no other extradural supratentorial neurenteric cyst. We present a patient with an extradural giant neurenteric cyst that occupied both the supratentorial and infratentorial compartments, further highlighting the heterogeneity of this rare intracranial lesion and emphasizing the need to consider this in the differential diagnosis of cystic intracranial brain lesions.
Topics: Brain; Humans; Male; Middle Aged; Neural Tube Defects; Treatment Outcome
PubMed: 20188565
DOI: 10.1016/j.jocn.2009.08.006 -
Strahlentherapie Und Onkologie : Organ... Oct 1995High-grade malignant gliomas have a dismal prognosis. Only achievement of long-term local control improves overall survival. Conventional treatments have not been... (Review)
Review
BACKGROUND
High-grade malignant gliomas have a dismal prognosis. Only achievement of long-term local control improves overall survival. Conventional treatments have not been successful, but thermoradiotherapy appears to be a promising new approach to this disease.
PATIENTS AND METHODS
The review addresses the various HT techniques applied for brain heating, the biological rationale and experimental studies supporting the use of heat in addition to radiotherapy for brain tumors. Normal brain damage exposed to heat is critically evaluated. Clinical trials implementing HT for tumors of the brain accumulating more than 400 patients are discussed.
RESULTS
HT is a feasible and effective approach to brain tumors. Important selection criteria are tumor size (< 6 cm) and location (supratentorial, peripheral). Acute treatment toxicity is relatively low and long-term side effects are similar to those observed for RT alone. In some studies a high response rate and improvement of survival was achieved. Tumor control and survival depend on histology (anaplastic astrocytoma vs. glioblastoma multiforme), extent of surgery (complete vs. incomplete), tumor status (primary vs. recurrent), age and performance status. Satisfactory heating also correlates significantly with favourable treatment outcome.
CONCLUSIONS
The encouraging results of clinical trials may be biased by favourable tumor and patient selection. Randomized clinical trials comparing RT alone versus combined RT-HT for advanced and recurrent brain tumors are justified. Part I has covered biological and technical fundamentals of clinical hyperthermia and has been published in Strahlenther. Onkol. 168 (1992), 183-190. Part II has covered clinical fundamentals and results in superficial tumors of clinical hyperthermia and has been published in Strahlenther. Onkol. 169 (1993), 633-654. Part III has covered clinical rationale and results in deep seated tumors and has been published in Strahlenther. Onkol. 171 (1995), 251-264.
Topics: Animals; Brain; Brain Neoplasms; Clinical Trials as Topic; Combined Modality Therapy; Disease Models, Animal; Humans; Hyperthermia, Induced; Prognosis
PubMed: 8571175
DOI: No ID Found -
Scientific Reports Jun 2022Only few studies have assessed brain shift caused by positional change. This study aimed to identify factors correlated with a large postneurosurgical positional brain...
Only few studies have assessed brain shift caused by positional change. This study aimed to identify factors correlated with a large postneurosurgical positional brain shift (PBS). Sixty-seven patients who underwent neurosurgical procedures had upright computed tomography (CT) scan using settings similar to those of conventional supine CT. The presence of a clinically significant PBS, defined as a brain shift of ≥ 5 mm caused by positional change, was evaluated. The clinical and radiological findings were investigated to identify factors associated with a larger PBS. As a result, twenty-one patients had a clinically significant PBS. The univariate analysis showed that supratentorial lesion location, intra-axial lesion type, craniectomy procedure, and residual intracranial air were the predictors of PBS. Based on the multivariate analysis, craniectomy procedure (p < 0.001) and residual intracranial air volume (p = 0.004) were the predictors of PBS. In a sub-analysis of post-craniectomy patients, PBS was larger in patients with supratentorial craniectomy site and parenchymal brain injury. A large craniectomy area and long interval from craniectomy were correlated with the extent of PBS. In conclusion, patients who undergo craniectomy and those with residual intracranial air can present with a large PBS. In post-craniectomy patients, the predisposing factors of a large PBS are supratentorial craniectomy, presence of parenchymal injury, large skull defect area, and long interval from craniectomy. These findings can contribute to safe mobilization among postneurosurgical patients and the risk assessment of sinking skin flap syndrome.
Topics: Brain; Brain Injuries; Craniotomy; Decompressive Craniectomy; Humans; Pneumocephalus; Postoperative Complications; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 35729166
DOI: 10.1038/s41598-022-13276-0 -
Neuroradiology Oct 2022Grey matter (GM) atrophy due to neuronal loss is a striking feature of patients with CLN3 disease. A precise and quantitative description of disease progression is...
PURPOSE
Grey matter (GM) atrophy due to neuronal loss is a striking feature of patients with CLN3 disease. A precise and quantitative description of disease progression is needed in order to establish an evaluation tool for current and future experimental treatments. In order to develop a quantitative marker to measure brain volume outcome, we analysed the longitudinal volumetric development of GM, white matter (WM) and lateral ventricles and correlated those with the clinical course.
METHODS
One hundred twenty-two MRI scans of 35 patients (21 females; 14 males; age 15.3 ± 4.8 years) with genetically confirmed CLN3 disease were performed. A three-dimensional T1-weighted sequence was acquired with whole brain coverage. Volumetric segmentation of the brain was performed with the FreeSurfer image analysis suite. The clinical severity was assessed by the Hamburg jNCL score, a disease-specific scoring system.
RESULTS
The volumes of supratentorial cortical GM and supratentorial WM, cerebellar GM, basal ganglia/thalamus and hippocampus significantly (r = - 0.86 to - 0.69, p < 0.0001) decreased with age, while the lateral ventricle volume increased (r = 0.68, p < 0.0001). Supratentorial WM volume correlated poorer with age (r = - 0.56, p = 0.0001). Supratentorial cortical GM volume showed the steepest (4.6% (± 0.2%)) and most uniform decrease with strongest correlation with age (r = - 0.86, p < 0.0001). In addition, a strong correlation with disease specific clinical scoring existed for the supratentorial cortical GM volume (r = 0.85, p = < 0.0001).
CONCLUSION
Supratentorial cortical GM volume is a sensitive parameter for assessment of disease progression even in early and late disease stages and represents a potential reliable outcome measure for evaluation of experimental therapies.
Topics: Adolescent; Atrophy; Biomarkers; Brain; Child; Disease Progression; Female; Gray Matter; Humans; Magnetic Resonance Imaging; Male; Membrane Glycoproteins; Molecular Chaperones; Neuronal Ceroid-Lipofuscinoses; Young Adult
PubMed: 35699772
DOI: 10.1007/s00234-022-02988-9 -
Journal of Neurosurgical Anesthesiology Oct 2014Compared with goal-directed crystalloid therapy, goal-directed colloid therapy during high-risk surgery may improve postoperative outcome. Whether intraoperative fluid... (Comparative Study)
Comparative Study Randomized Controlled Trial
The brain relaxation and cerebral metabolism in stroke volume variation-directed fluid therapy during supratentorial tumors resection: crystalloid solution versus colloid solution.
BACKGROUND
Compared with goal-directed crystalloid therapy, goal-directed colloid therapy during high-risk surgery may improve postoperative outcome. Whether intraoperative fluid therapy based on goal-directed protocol with different types of fluid has distinctive effects on brain relaxation and cerebral metabolism during craniotomy remains unclear.
METHODS
Forty patients with supratentorial brain tumors undergoing craniotomy were randomly assigned to either a Ringer's Lactate-based goal-directed group (LR group, n=20) or a 6% hydroxyethyl starch-based goal-directed group (HES group, n=20). The goal was achieved by maintaining a target stroke volume variation (SVV<13%) by volume loading with LR or HES throughout the procedure. The primary outcome is brain relaxation scales, an indirect evaluation of ICP; secondary endpoints include cerebral metabolism variables (jugular venous oxygen saturation [SjvO(2)], arterial-jugular venous differences in oxygen [CajvO(2)], glucose [A-JvGD], lactate [A-JvLD], and cerebral extraction ratio for oxygen [CERO(2)]) and fluid volumes.
RESULTS
There is no significant difference between the LR and HES groups on brain relaxation scales (P=0.845), or measures of cerebral oxygenation and metabolism. Intragroup comparisons showed that CERO(2) increased by 14.3% (P=0.009, LR group) and 13.2% (P=0.032, HES group), respectively, and SjvO(2) was decreased by 8.8% (P=0.016, LR group) and 8.1% (P=0.026, HES group), respectively, after tumor removal, compared with baseline. During surgery, the LR group (3070±1138 mL) received more fluid than the HES group (2041±758 mL, P=0.002).
CONCLUSIONS
In patients undergoing supratentorial tumor resection, goal-directed HES therapy was not superior to goal-directed LR therapy for brain relaxation or cerebral metabolism, although less fluid was needed to maintain the target SVV in the HES-based group than in the LR-based group.
Topics: Adult; Analysis of Variance; Brain; Colloids; Crystalloid Solutions; Female; Fluid Therapy; Humans; Hydroxyethyl Starch Derivatives; Isotonic Solutions; Male; Middle Aged; Plasma Substitutes; Stroke Volume; Supratentorial Neoplasms
PubMed: 24487733
DOI: 10.1097/ANA.0000000000000046 -
Pediatric Radiology Sep 2004The aim of this review is to emphasize the role of fetal MR in the evaluation of the supratentorial space. The advantages of MRI compared to US are stressed in three... (Review)
Review
The aim of this review is to emphasize the role of fetal MR in the evaluation of the supratentorial space. The advantages of MRI compared to US are stressed in three fields of application: cerebral biometry, sulcation and cerebral parenchyma. In each field, normal data are displayed and MR applications with patterns of the main pathologies are briefly described.
Topics: Biometry; Brain; Female; Fetal Diseases; Fetus; Humans; Magnetic Resonance Imaging; Pregnancy; Prenatal Diagnosis
PubMed: 15316690
DOI: 10.1007/s00247-004-1249-x -
Cerebellum (London, England) Sep 2009Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Studies of human TBI demonstrate that the cerebellum is sometimes affected even when... (Review)
Review
Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Studies of human TBI demonstrate that the cerebellum is sometimes affected even when the initial mechanical insult is directed to the cerebral cortex. Some of the components of TBI, including ataxia, postural instability, tremor, impairments in balance and fine motor skills, and even cognitive deficits, may be attributed in part to cerebellar damage. Animal models of TBI have begun to explore the vulnerability of the cerebellum. In this paper, we review the clinical presentation, pathogenesis, and putative mechanisms underlying cerebellar damage with an emphasis on experimental models that have been used to further elucidate this poorly understood but important aspect of TBI. Animal models of indirect (supratentorial) trauma to the cerebellum, including fluid percussion, controlled cortical impact, weight drop impact acceleration, and rotational acceleration injuries, are considered. In addition, we describe models that produce direct trauma to the cerebellum as well as those that reproduce specific components of TBI including axotomy, stab injury, in vitro stretch injury, and excitotoxicity. Overall, these models reveal robust characteristics of cerebellar damage including regionally specific Purkinje cell injury or loss, activation of glia in a distinct spatial pattern, and traumatic axonal injury. Further research is needed to better understand the mechanisms underlying the pathogenesis of cerebellar trauma, and the experimental models discussed here offer an important first step toward achieving that objective.
Topics: Animals; Brain Injuries; Cerebellum; Disease Models, Animal; Humans; Purkinje Cells
PubMed: 19495901
DOI: 10.1007/s12311-009-0114-8 -
Pediatric Research Jan 2006The aim of this study was to specify the early setting of the particular craniofacial morphology in Down syndrome during the fetal period from data based on postmortem...
The aim of this study was to specify the early setting of the particular craniofacial morphology in Down syndrome during the fetal period from data based on postmortem examinations. The study included 1277 fetuses at 15-38 gestational weeks (GW): 922 control fetuses and 355 fetuses with trisomy 21, selected from fetopathology units in Paris. Body weight (BW) and nine dimensions of the face, skull, and brain were recorded: the outer and inner canthal distances (OCD, ICD), biparietal diameter (BPD), head circumference (HC), brain weight (BrW), occipitofrontal diameters of left and right hemispheres (lOFD, rOFD), weight of the infratentorial part of the brain (IBW), and maximal transversal diameter of the cerebellum (CTD). Four ratios were computed: BPD/HC, OCD/BPD, BrW/BW, IBW/BrW. Differences between trisomic fetuses and control fetuses were tested by age interval. Results showed that BW, rOFD, and lOFD were lower in trisomic fetuses as early as 15 GW. Cerebellar hypoplasia included lower IBW and CTD in trisomic fetuses. The IBW/BrW ratio was higher in trisomic fetuses, showing that growth restriction affected the infratentorial part of the brain less than the supratentorial part. Early brachycephaly was found in trisomic fetuses, with higher values of BPD and BPD/HC from 15 GW. ICD and OCD were not significantly different in the two groups, but OCD/DBP ratio was lower in trisomic fetuses. These results confirm the early phenotypical expression of trisomy 21 on craniofacial morphology, associated with a marked restriction of brain growth, especially in the supratentorial part.
Topics: Biometry; Brain; Craniofacial Abnormalities; Down Syndrome; Fetus; Humans; Organ Size
PubMed: 16326987
DOI: 10.1203/01.pdr.0000190580.88391.9a