Ebook Case-Based brain imaging (2nd edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Case-Based brain imaging (2nd edition): Part 2
Ebook Case-Based brain imaging (2nd edition): Part 2
Section IVNeurodegenerativef White Matter Diseases/ MetabolicCase 85Clinical PresentationA 2S-year-old woman presents will) leg, weakness.Radiologic F Ebook Case-Based brain imaging (2nd edition): Part 2FindingsFig. 85.1 Multiple dxial 12-W HAIR itiidqes demonstrate scattered periventricular foci of T? prolongation radiating from ventricles (A), within the left brachium ponlis (B). and within the spleiiium OÍ die toipus Cdl-losum (C) in a pattern typical of demyelination as seenwith multiple sclero Ebook Case-Based brain imaging (2nd edition): Part 2sis. I he lesion within the corpus callosum demonstrates enhancement on rhe postcontrast TIW image (Di and restricted diffusion on the DW1 (El with maEbook Case-Based brain imaging (2nd edition): Part 2
tching ADC (F) siqiidl consistent with dll active region of demyelination.DiagnosisMultiple sclerosis (MS;Differential Diagnosis•Acute disseminated enSection IVNeurodegenerativef White Matter Diseases/ MetabolicCase 85Clinical PresentationA 2S-year-old woman presents will) leg, weakness.Radiologic F Ebook Case-Based brain imaging (2nd edition): Part 2 of MS)•Microvascular ischemic disease (older patient, typically sparing of corpus callosum and subcortical l J fibers, lack of enhancement)•Vasculitis (small chronic infarctions and leptomeningeal enhancement may be seen)•Neoplasm (typically more mass effect, rarely involves the corpus callosum unl Ebook Case-Based brain imaging (2nd edition): Part 2ess glioblastoma or lymphoma)4114 12 CASE-BASED BRAIN IMAGING•Neurosarcoidosis (may see leptomeningeal enhancement, and the corpus callosum is not typEbook Case-Based brain imaging (2nd edition): Part 2
ically involved)•Progressive multifocal leukoencephalopathy (corpus callosum is not typically involved-only 2% of white matter diseases other than MS Section IVNeurodegenerativef White Matter Diseases/ MetabolicCase 85Clinical PresentationA 2S-year-old woman presents will) leg, weakness.Radiologic F Ebook Case-Based brain imaging (2nd edition): Part 2adults, generally having onset between 20 and 45 years of age. although 13% of cases present before age 20 and 15% after age 50. MS is more common in women than men with a ratio of 3:2. The clinical definition of MS requires that the patient demonstrate evidence of lesions separated in time and spac Ebook Case-Based brain imaging (2nd edition): Part 2e. Separation in time requires two attacks each lasting at least 24 hours involving different parts of the CNS and separated by at least 1 month. SepaEbook Case-Based brain imaging (2nd edition): Part 2
ration in space requires clinical evidence of distinct neurologic deficits and/or MR1 evidence of separate CNS lesions. Pathologically. MS is characteSection IVNeurodegenerativef White Matter Diseases/ MetabolicCase 85Clinical PresentationA 2S-year-old woman presents will) leg, weakness.Radiologic F Ebook Case-Based brain imaging (2nd edition): Part 2known, but it IS likely an autoimmune reaction to an environmental stimulus in a genetically susceptible individual.Clinical FindingsThe presentation varies with the location of lesions. Focal motor and sensory deficits are typical, with headache 01 seizures being less common presenting symptoms, op Ebook Case-Based brain imaging (2nd edition): Part 2tic nerve involvement is common, and patients may present with acute visual changes due to optic neuritis. Spinal cord involvement may cause myelopathEbook Case-Based brain imaging (2nd edition): Part 2
ic symptoms. Most patients have a chronic relapsing and remitting course, although some patients may demonstrate steady progression of deficits.The McSection IVNeurodegenerativef White Matter Diseases/ MetabolicCase 85Clinical PresentationA 2S-year-old woman presents will) leg, weakness.Radiologic F Ebook Case-Based brain imaging (2nd edition): Part 2dissemination of lesions in time and space. Criteria include clinical and MR imaging findings.ComplicationsBlindness, paralysis, dementia, and loss of sphincter control may develop as the disease progresses.Clinical Subtypes•Relapsing-remittmg (RR) is the most common initial presentation of patients Ebook Case-Based brain imaging (2nd edition): Part 2 (85%)•Secondary-progressive (SP) is considered the usual progression of disease from RR. By 10 years 50% of RR and by 25 years 90% of RR patients entEbook Case-Based brain imaging (2nd edition): Part 2
er SP phase.•Primary-progressive (PP): 5-10% of MS patients are progressive from initial presentation.•Progressive-relapsing (PR): rare progressive diSection IVNeurodegenerativef White Matter Diseases/ MetabolicCase 85Clinical PresentationA 2S-year-old woman presents will) leg, weakness.Radiologic F Ebook Case-Based brain imaging (2nd edition): Part 2ts•Marburg: younger patients typically presenting with febrile prodrome and a clinically fulminant course with death in monthsSection IVNeurodegenerativef White Matter Diseases/ MetabolicCase 85Clinical PresentationA 2S-year-old woman presents will) leg, weakness.Radiologic FGọi ngay
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