外伤性基底节血肿11例临床分析

同顾总结11例外伤性基底节区血肿(TBGH)的临床资料,分析探讨其发病机制和临床特点.TBGH多由交通事故引发,大多为对冲伤,常伴发肢体功能障碍,临床上需与高血压脑出血鉴别.     

外伤性颅后窝血肿35例临床分析

探讨外伤性颅后窝血肿的临床特点和治疗。认为外伤性颅后窝血肿应进行早期诊断和治疗，以降低致残率和死亡率。     

外伤性颅后窝血肿35例临床分析

探讨外伤性颅后窝血肿的临床特点和治疗.认为外伤性颅后窝血肿应进行早期诊断和治疗,以降低致残率和死亡率.     

外伤性进展型颅内血肿118例临床分析

外伤性进展型颅内血肿，临床上较为常见，其发生机制和临床均有一些特点。1995年5月～2004年9月，我院收治外伤性进展型颅内血肿118例，占同期收治颅内血肿的13．5％，现就诊断与治疗分析如下。     

外伤性后颅窝硬膜外血肿11例分析

外伤性后颅窝硬膜外血肿在临床上相对少见，我院1996年5月-2005年12月共收治11例，现报告如下。     

外伤性进展性颅内血肿93例诊治分析

1996年1月～2004年12月,我们共收治外伤后进展性颅内血肿93例,占同期收治颅内血肿的11．3％。现分析报告如下。     

迟发性外伤性硬脑膜外血肿

迟发性外伤性硬脑膜外血肿２００００３上海第二军医大学长征医院梁玉敏卢亦成朱诚江基尧张光霁杨中坚白如林丁学华关键词血肿，硬膜外；诊断学中国图书资料分类号Ｒ６５１．１５我院１９８４年４月～１９９２年８月收治１８例迟发性外伤性硬脑膜外血肿（ＥＴＥＤＨ），占...     

Traumatic basal ganglia hematoma in a fatal traffic accident victim

A 41-year-old male driver involved in a fatal traffic accident presented with a basal ganglia hematoma on postmortem computed tomographic imaging. Clinicians could not exclude the possibility of non-traumatic intracerebral hemorrhage as the underlying cause of the traffic accident. However, analysis of the head injuries showed that the hematoma was caused by an impact to the front-parietal region directed toward the tentorium. The absence of hypertensive arteriolar changes and hemosiderin deposits in the brain supported the traumatic origin of the hematoma.     

Traumatic hematomas of the adrenal glands: CT and US findings in 3 cases

Traumatic hematomas of the adrenal gland are but little known; they are but seldom discussed in literature, and can be demonstrated only by US and CT due to their small size. These lesions are mostly located on the right side, probably following a direct trauma of the adrenal parenchyma against vertebral bodies, or as a result of the rupture of medullary sinusoids for a sharp rise in pressure into the inferior vena cava, during trauma. Bilateral traumatic hematomas can cause severe adrenal failure, and the healing is slow, without calcifications, and takes several months. Three new cases are reported, unilateral on the right adrenal bed. In 2 patients CT demonstrated a slight parenchymal enlargement after thoraco-abdominal traumas; the patients were young and healthy, and the lesions completely disappeared in some years. US detected a third hematoma in a young woman with suspected metastasis from ovarian carcinoma: CT confirmed the parenchymal swelling, and a percutaneous transhepatic biopsy clarified the diagnosis. Adrenal hematomas are to be reported in order to avoid confusing them with neoplastic lesions, even though only percutaneous biopsy allows a quick and reliable diagnosis.     

MR volumetric analysis of the human basal ganglia: normative data

RATIONALE AND OBJECTIVES: The authors undertook this study to identify a precise, semiautomated, reproducible magnetic resonance (MR) imaging technique for measuring the basal ganglia, to establish normative volumetric data, and to verify the presence of previously reported asymmetries. MATERIALS AND METHODS: Twenty-eight healthy adults underwent cranial MR examination. The volumes of the various components of the basal ganglia were measured by means of a combination of thresholding and manual tracing techniques performed with specialized software. The validity of these measurements was assessed by fashioning, imaging, and measuring a practical basal ganglia phantom. Measurement accuracy was also established by means of inter- and intrarater reliability indexes. Normalized volumes were statistically analyzed with analysis of variance and paired t tests. RESULTS: The absolute values of the various components of the basal ganglia varied widely even though the volumes were normalized to differences in intracranial volume. The right caudate nucleus volume was significantly (P < .000001) larger than the left in both men and women and in both right-handed and non-right-handed subjects. This asymmetry led to an increase in the overall volume of the basal ganglia on the right. CONCLUSION: The authors have defined a precise, reproducible technique for measuring various components of the basal ganglia and have established normative data. The basal ganglia, similar to other brain structures, exhibit hemispheric lateralization.     

迟发性外伤性脑内血肿33例临床分析

探讨迟发性外伤性脑内血肿(DTICH)的发病机制及防治措施,强调手术方式的选择和手术时机的掌握,是降低死亡率及致残率的关键.     

1H MR spectroscopy of the basal ganglia in childhood: a semiquantitative analysis

Proton MR spectra of the basal ganglia were obtained from 28 patients, 24 male and 14 female, median age 16.3 months (5 weeks to 31 years). They included 17 patients with normal MRI of the basal ganglia without metabolic disturbance (control group) and 11 patients with various metabolic diseases: one case each of high serum sodium and high serum osmolarity, cobalamin C deficiency, Leigh disease, Galloway-Mowat syndrome, Pelizaeus-Merzbacher disease, hemolytic-uremic syndrome and Wilson disease and two cases of Alagille syndrome and methylmalonic acidemia with abnormal MRI of the basal ganglia or blood or urine analysis (abnormal group). The MR spectrum was measured by using STEAM. The MR-visible water content of the region of interest was obtained. Levels of myoinositol, choline, creatine and N -acetylaspartate were measured using a semiquantitative approach, with absolute reference calibration. In the control group, there was a gradual drop of water content over the first year of life; N -acetylaspartate, creatine and myoinositol levels showed no significant change with age, in contrast to the occipital, parietal and cerebellar regions. Choline showed a gradual decrease for the first 2 years of life and then remained fairly constant. In the abnormal group the water content was not significantly different. N -Acetylaspartate was decreased in patients with high serum sodium and high serum osmolarity, cobalamin C deficiency, Leigh disease and one case of methylmalonic acidemia. Decreased creatine was also found in Leigh disease, and decreased choline in Galloway-Mowat syndrome and Wilson disease. Myoinositol was elevated in the patient with abnormally high serum sodium, and decreased in the hemolytic-uremic syndrome. Received: 31 January 1997 Accepted: 31 January 1997     

Biotin-thiamine-responsive basal ganglia disease: A case report

Biotin-Thiamine-Responsive Basal Ganglia Disease is an extremely rare autosomal recessive neurometabolic disorder characterized by recurrent waxing and waning episodes of subacute encephalopathy and seizures. High dose biotin and thiamine administration has been shown to improve symptoms within days, and the symptoms may reappear rapidly if supplementation is discontinued. Here we present a case of a 20-year-old male with classical clinical and imaging findings of Biotin-Thiamine-Responsive Basal Ganglia Disease, with a 12-year delay in diagnosis, finally diagnosed after presenting at our institution based on imaging and subsequent reexamination of exome sequencing. In this report, we review the classic imaging findings in this disease and examine why making the diagnosis can be extremely challenging due to its wide differential. Both clinically and radiographically, this condition demonstrates significant overlap with a vast array of disease entities, ranging from viral or autoimmune encephalitis to metabolic disorders. Finally, we discuss the various negative prognostic predictors described in the literature, several of which were observed in this patient''s clinical course.     

Involvement of the basal ganglia in refractory epilepsy: an 18F-fluoro-L-DOPA PET study using 2 methods of analysis.

Studies in animal models and epileptic patients have led to the suggestion that the basal ganglia (BG) are involved in seizures. PET with 6-18F-L-3,4-fluorodihydroxyphenylalanine (18F-fluoro-L-DOPA) has recently demonstrated a reduction of striatal dopamine uptake in drug-resistant epileptic patients with ring chromosome 20 (r20) using a multiple-time graphical analysis. The aim of the present study was to evaluate the involvement of dopamine in other epileptic syndromes using a multiple-time graphical analysis and the all-brain statistical parametric mapping (SPM) analysis. METHODS: Patients with drug-resistant epilepsy were divided into 3 groups: group 1, with r20 epilepsy (n = 16; mean age +/- SD, 21.5 +/- 5.4 y); group 2, with resistant generalized "absence-like" epilepsy (n = 10; mean age, 32.3 +/- 11.4 y); and group 3, with drug-resistant temporal lobe epilepsy with hippocampal sclerosis (n = 9; mean age, 35.2 +/- 10.3 y). We compared 2 strategies of analysis of the 18F-fluoro-L-DOPA uptake constant (K(i), min(-1)) in BG using a multiple-time graphical analysis using regions of interest (the gold-standard method) and an SPM analysis using a voxel-by-voxel statistical t test to avoid a priori hypotheses in the analysis. Each epileptic group was compared with a group of healthy volunteers (n = 10; mean age, 45.1 +/- 16.5 y). RESULTS: A decrease of the mean K(i) value was observed in the striatum in all groups of patients with both types of analysis. With multiple-time graphical analysis, the reduction was evident using the averaged K(i) values over both hemispheres in each BG. Unilateral decreases in each BG were detected in SPM analysis. A ratio of decrease of 18F-fluoro-L-DOPA uptake was observed in the 3 groups of patients. Only the SPM analysis showed a decrease of 18F-fluoro-L-DOPA uptake ipsilateral to the seizure side in patients with temporal lobe epilepsy. Moreover, the all-brain SPM analysis showed a decrease of 18F-fluoro-L-DOPA uptake in the substantia nigra bilaterally (P < 0.001). CONCLUSION: This result confirms the involvement of dopamine neurotransmission in seizure control related to the type of epileptic syndrome. The difference in epileptic types may depend in part on the seizure frequency.