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Acute Spinal-Cord Ischemia: Evolution of MRI Findings
Cornelis L. Alblas,Willem H. Bouvy,Geert J. Lycklama à Nijeholt,Jelis Boiten 대한신경과학회 2012 Journal of Clinical Neurology Vol.8 No.3
Background and Purpose Magnetic resonance (MR) findings in acute spinal-cord ischemia can be summarized as focal cord enlargement and hyperintensities on T2-weighted images and gadolinium enhancement, especially of the central gray matter. However, in analogy with acute brain ischemia, it is to be expected that the findings of MR imaging (MRI) may be normal in the first hours after symptom onset. We evaluated the clinical and MRI findings in a series of patients with acute spinal-cord ischemia, and tested the hypothesis that the development and course of MR abnormalities are predictable. Methods Five patients with acute spinal-cord ischemia were admitted to our hospital over a 2-year period. Repeated MRI (1.5 T) was performed in all patients. Clinical data were retrieved from the patients’ charts. Results Four women and one man with a median age of 52 years (range, 31-75 years) were admitted. Three patients had anterior spinal artery infarction and two patients had transverse infarctions. All patients underwent spinal MRI within 24 hours; the findings were normal in four of the five patients. After 1-2 days, T2-weighted MRI generally exhibited focal cord enlargement and hyperintensity in all patients, while spinal-cord enhancement appeared after 2-11 days. Conclusions Acute spinal-cord ischemia may have a typical course on MRI. MRI findings are usually normal in the acute phase, but spinal cord swelling and T2 abnormality are expected after several days, while gadolinium enhancement appears even later after symptom onset. The sensitivity and specificity of MRI can be increased by repeated MRI in patients suspected of acute spinal-cord ischemia.
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Unilateral Reversible Posterior Leukoencephalopathy Syndrome after Coiling of an Aneurysm
Willemijn Huijgen,Bas van der Kallen,Jelis Boiten,Geert Lycklama à Nijeholt 대한신경과학회 2014 Journal of Clinical Neurology Vol.10 No.1
Background Reversible posterior leukoencephalopathy syndrome (RPLS) is radiologicallycharacterized by symmetrical subcortical areas of vasogenic edema that are preferentially parieto-occipital, and it typically resolves after appropriate treatment. Case Report We present a patient with strikingly unilateral RPLS that developed 21 days aftercoiling of an anterior communicating artery aneurysm and several days of triple-H therapy. Cortical and subcortical vasogenic edema and enhancement developed only in the left hemisphere, with a pattern suggesting RPLS. After 7 months the lesions had nearly completely resolved. Conclusions The pathophysiological mechanism underlying RPLS is still not well understood, which makes it difficult to explain the unilateral appearance in this case. Since the imaging findings may be confused with other conditions such as ischemia, recognition of RPLS after coiling is necessary in order to avoid inadequate treatment.
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Rikangsou Tchouhla,Merlin Gountié Dedzo,Boris Chako-Tchamabé,Gervais Onana,Djamilatou Diddi Hamadjoda,Pierre Christel Biakan à Nyotok,Klamadji Moussa Ngarena,Asobo Nkengmatia Elvis Asaah,Pierre Kamgan 한국지질과학협의회 2023 Geosciences Journal Vol.27 No.2
This study presents major and trace elements, and Sr-Nd-Pb isotope data of the Mokolo-Kosséhone volcanic rock (basanite, trachybasalt, trachyte, and rhyolite) from the northernmost segment of the Cameroon Volcanic Line (CVL). The basanite sample exhibits primitive character (MgO: 12–14 wt%; Mg#: 69–72; Ni: 327–427 ppm; Cr: 524–599 ppm; Co: 57–60 ppm). Trace element and isotopic signatures of the mafic lavas are similar to those of OIB. The trends observed in the major oxides and compatible trace elements against SiO2 from basanite to rhyolite are attributed to the fractionation of different mineral phases such as Fe-Ti oxides, olivine, clinopyroxene, feldspar, and quartz. The enrichment in LREEs and depletion in HREEs associated with (La/Yb)N > 5 (12.39–32.65), (Tb/Yb)N > 1.7 (1.71–2.89), and Dy/Yb > 2 (2.16–3.63), suggest the presence of a garnet phase in a mantle source. The lavas were produced at varying depths by low degrees of partial melting (< 4%) of a source containing less than 5% of garnet peridotite. The 206Pb/204Pb values of basanite (19.69630–19.79122) are similar to those of FOZO (206Pb/204Pb > 19.5). The trachybasalt samples with 206Pb/204Pb values of 19.25 and 19.37 suggest the probable enrichment of magma with a high-μ (HIMU) signature (206Pb/204Pb < 19.5) by a crustal component. Trace elements and isotopic compositions (87Sr/86Sr: 0.70308–0.70378, 143Nd/144Nd: 0.51287–0.51296, 206Pb/204Pb: 19.24652–19.79122) of the Mokolo-Kosséhone lavas are consistent with a mixture of different source material from the sub-continental lithospheric mantle (SCLM) and the asthenosphere with minor crustal contamination. The composition of the source is analogous to those described in the northern portion of the CVL and other volcanic massifs along the CVL.
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