The potential role of brain asymmetry in the development of adolescent idiopathic scoliosis: a hypothesis.

BACKGROUND: The size asymmetry of cerebral hemispheres may predispose to head tilt and asymmetric blocking of the zygapophysial joints, potentially leading to the development of compensatory curvatures in the lower segments of the spine. OBJECTIVE: To analyze the effects of spinal manipulation, maintained by an exercise program, on the progression of idiopathic adolescent scoliosis in 2 children aged 6 and 10. CLINICAL FEATURE: The scoliosis found was 16 and 60 degrees. INTERVENTION AND OUTCOME: For diagnosis and monitoring of therapy, we recorded qualitative parameters of shoulder asymmetry, axillary line asymmetry, and scapular angle position. Manual treatment consisted of the examinations of all sliding motion in zygapophysial joints and both sacroiliac joints and removing the limitations of the sliding motions according to the method of Karel Lewit. The treatment procedure consisted of 3 or 4 manipulations within 17 months and an exercise program. The manipulation effects were maintained by the exercise program. The exercises were done in 2 or 3 sessions weekly for a year. In both patients we observed that scoliosis decompensation was successfully stopped and the effects of the correction persisted for 10 years. CONCLUSION: Brain and head asymmetry may be only a transient state, predisposing to asymmetric blocking at the atlanto-occipital level. Removal of blocking may prevent curve progression in children who had adolescent idiopathic scoliosis. The manipulative therapy may also have a promising effect on retarding curve progression when used in skeletally immature patient.     

Imaging in acute brain infarction

Imaging in a patient suspected of having suffered an acute stroke is used primarily to clear the patient for thrombolytic therapy, by excluding intracranial hemorrhage and nonstroke causes of the patient's symptoms, within a critical 3-hour window. Noncontrast CT of the brain is the imaging test of choice for the initial evaluation of a patient with suspected acute ischemic stroke. It is rapid and readily available and has a high sensitivity for intracranial hemorrhage. Contrast-enhanced CT angiography and perfusion imaging may provide additional information with only a minimal increase in scanning time. Finally, diffusion-weighted magnetic resonance sequences have a high sensitivity for acute stroke and, with magnetic resonance perfusion imaging, may play an increasing role in the future treatment of stroke.     

青少年腰椎峡部裂的影像学特征及新疗法

目的探讨青少年腰椎峡部裂的影像学特征及新疗法,提高对该病的诊断能力并为该病的治疗提供新思路。 方法回顾性分析1例接受C臂机引导下于L₅峡部裂断端处注射金葡素治疗L₅峡部裂患者的影像学特征及疾病转归。 结果患者X线片表现为L₅椎间孔后上壁不连续,出现明显裂隙,形成典型"项圈征";CT扫描表现为L₅双侧峡部骨质不连续,呈裂隙状,其边缘增生硬化凹凸不平呈锯齿状改变,形成典型"裂隙征"与"碎裂征";L₅双侧峡部裂诊断明确,采用C臂机引导下于L₅峡部裂断端处注射金葡素治疗。随访12个月,患者症状、体征较术前改善显著且断端获得骨性愈合。 结论腰椎峡部裂的诊断主要依赖于影像学检查,因此深入了解其影像学特征、掌握诊断要点,对准确诊断腰椎峡部裂尤为重要;另外,C臂机引导下于腰椎峡部裂断端处注射金葡素疗法独到新颖、疗效确切、安全微创、经济方便,值得推广应用。     

粘多糖病颅脑病变影像学表现1例

粘多糖病（mucopolysaccharidosis,MPS）是一类遗传性代谢性疾病，其骨骼病变的影像学研究已较透彻，但有关MPS神经系统表现报道甚少，国内影像学文献仅有CT检查个案报告，国外有关MPS颅脑的断面成像报道也只见7篇。作者报告1例经临床，骨骼异常及颅内病变证实的CT与MRI表现。     

粘多糖病颅脑病变影像学表现1例

粘多糖病(mucopolysaccharidosis,MPS)是一类遗传性代谢性疾病[1-4],其骨骼病变的影像学研究已较透彻,但有关MPS神经系统表现报道甚少,国内影像学文献仅有CT检查个案报告[5],国外有关MPS颅脑的断面成像报道也只见7篇[1-4,6-8]。作者报告1例经临床、骨骼异常及颅内病变证实的CT与MRI表现。病例男,3岁。自幼头大、智力障碍、双侧突眼及视力减退,近来加重。体检:发际低,鼻根短而平,舌大、过伸,手掌宽厚,指粗短,脾大。眼内压增高,右侧为43.4mmHg、左侧为53.6mmHg。双侧角膜混浊,眼底显示不清。眼距过宽、眼裂增大。心肺无异常,未引出病…     

Imaging the neurochemical brain in health and disease

Neurochemical transmission is a fundamental element of brain organisation that has been relatively unexplored in the living human brain. Continuing advances in radionuclide imaging, particularly positron emission tomography (PET) and single photon emission tomography (SPET), mean that elements of neurochemical transmission can now be directly measured in vivo. With these techniques convincing abnormalities of monoaminergic neurotransmitter systems have been revealed in illnesses such as Parkinson's disease and schizophrenia. Furthermore, mechanisms of drug action and treatment responses can be monitored in vivo. This brief review describes some of our recent attempts to image the neurochemical brain in health and disease at the MRC Cyclotron Unit, Hammersmith Hospital, London.     

Imaging brain plasticity: conceptual and methodological issues--a theoretical review

The neural plasticity associated with learning and development is increasingly being studied using functional neuroimaging methods such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). In this paper I outline a set of conceptual and methodological issues that are particularly relevant for the study of neural plasticity. A number of confounds, related to changes in performance and the inherently temporal nature of learning and development, must be addressed when imaging plasticity. The interpretation of changes in imaging signals is greatly underdetermined, suggesting that hypothesis-driven research approaches may be most fruitful. Finally, I argue that the imaging of learning-related and developmental plasticity can enhance the ability of functional neuroimaging to identify and characterize the underlying neural basis of cognition.     

单纯脑泡型包虫阿苯达唑治疗后影像分析

目的：分析单纯脑泡型包虫的影像表现及阿苯达唑治疗后影像变化。方法：搜集拟诊脑泡型包虫经阿苯达唑治疗后病例进行影像回顾性分析。CT扫描12例,CT、MRI同时扫描8例。CT增强扫描12例,其中脑内不规则钙化10例。所有患者血或脑积液酶联免疫吸附试验、间接血实验、包虫皮试2项以上阳性。结果：脑实质型5例,脑室型4例,脑膜型2例,混合型1例。不规则低密度影伴钙化并周边实质水肿9例,单纯钙化3例;不规则低密度影伴钙化7例;合并脑积水1例,脑水肿3例。结论：脑泡型包虫影像表现多样,但具有一定特征;可进行阿苯达唑诊断性治疗,能够缓解症状,达到临床治疗的目的。     

Perspectives in adolescent risk-taking through instrument development

Understanding the high-risk adolescent's perception of risk taking is essential for health professionals to determine appropriate interventions. The purpose of this study was to examine the psychometric properties of the revised Adolescent Risk-Taking Instrument (ARTI) designed to measure the high-risk adolescent's perception of risk taking. This study also examined the variables that are most predictive of social adaptation and risk taking. An ex post facto design was used to standardize data collection and to assess the psychometric properties of the revised ARTI. The nonprobability sample consisted of 167 adolescents attending school in an urban, health-underserved area. Exploratory factor analysis supported construct validity, and Chronbach's Coefficient Alpha supported internal consistency reliability. The reliability coefficient for the risk taking and social adaptation constructs were .80 and .77, respectively. Current perspectives on adolescent risk taking and implications for the use of the ARTI in clinical practice are addressed.     

Child brain development

Although the human brain is formed before birth, it continues to develop for at least 20 years. Four main developmental stages are described: before birth; birth to five years; five to 10 years; and 10 to 20 years. Specific developmental skills are attained by an individual at each of these stages. Familiarization by carers and healthcare professionals of what is normal for each stage will aid in the identification of potential problems in a child's cognitive development.     

Diffusion tensor imaging-based tissue segmentation: validation and application to the developing child and adolescent brain

We present and validate a novel diffusion tensor imaging (DTI) approach for segmenting the human whole-brain into partitions representing grey matter (GM), white matter (WM) and cerebrospinal fluid (CSF). The approach utilizes the contrast among tissue types in the DTI anisotropy vs. diffusivity rotational invariant space. The DTI-based whole-brain GM and WM fractions (GMf and WMf) are contrasted with the fractions obtained from conventional magnetic resonance imaging (cMRI) tissue segmentation (or clustering) methods that utilized dual echo (proton density-weighted (PDw)), and spin-spin relaxation-weighted (T2w) contrast, in addition to spin-lattice relaxation weighted (T1w) contrasts acquired in the same imaging session and covering the same volume. In addition to good correspondence with cMRI estimates of brain volume, the DTI-based segmentation approach accurately depicts expected age vs. WM and GM volume-to-total intracranial brain volume percentage trends on the rapidly developing brains of a cohort of 29 children (6-18 years). This approach promises to extend DTI utility to both micro and macrostructural aspects of tissue organization.