OBJECTIVES: Alzheimer's disease (AD) and normal pressure hydrocephalus (NPH) are both associated with cognitive decline and ventriculomegaly. While promising approach in differentiating between the two diseases, only a few diffusion tensor imaging (DTI) studies compared directly NPH and AD patients. The current study compares global whitematter (WM) alterations in AD and NPH addressing some of the methodological issues of previous studies. PATIENTS AND METHODS: Diffusion tensor images were obtained from 17 patients with NPH, 14 with AD, and 17 healthy controls. White matter integrity was quantified by fractional anisotropy (FA), mean (MD), axial (λ1) and radial diffusivity (RD). The diffusion parameters were compared between the groups in 'skeletonised' tracts representing the core of the fibre bundles. RESULTS: Reduced FA was found in NPH patients throughout the corpus callosum, particularly in the splenium, along with increased RD. On the other hand, FA, MD and RD were higher in NPH in the cortico-fugal fibres arising from the frontal and parietal cortex. While no FA changes were detected in AD patients compared to controls, widespread increased RD was observed. When comparing NPH and AD patients, higher FA, MD and RD was observed in the corona radiata in the periventricular fibres arising from the frontal and parietal cortex in NPH patients. The ventricular volumes were correlated with diffusivity parameters in the tracts next to the ventricles in AD and NPH patients. CONCLUSION: Our analysis identified a pattern of WM diffusion alterations that can differentiate NPH patients from controls and AD patients.

• MeSH
• Alzheimer Disease diagnosis   pathology   MeSH
• Anisotropy MeSH
• White Matter pathology   MeSH
• Diagnosis, Differential * MeSH
• Middle Aged MeSH
• Humans MeSH
• Hydrocephalus, Normal Pressure diagnosis   pathology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Diffusion Tensor Imaging methods   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Bobble-head doll syndrome (BHDS) is a complex syndrome with the dominant symptom of repetitive anteroposterior head movement. Only 57 patients are quoted in the literature. The etiology of this syndrome remains unknown and no standard treatment has yet been established. We hereby report four cases treated at our department. All the patients presented a psychomotor retardation due to an obstructive hydrocephalus. All the patients were treated using neuroendoscopic techniques: two with ventriculocystostomy, and two with ventriculocystocisternostomy. Cyst decompression was achieved in all four cases and clinical recovery was evident in three of the four patients observed. After surgery, BHDS persisted longer the more the subsequent treatment was delayed. In this article, we provide a concise overview of the theories of pathogenesis, presentation, and management of this syndrome. Based on our own experience, we state that the method of choice should be the neuroendoscopy and this must be performed promptly after diagnosis is made.

• MeSH
• Arachnoid Cysts complications   surgery   MeSH
• Child MeSH
• Dyskinesias complications   surgery   MeSH
• Head Movements physiology   MeSH
• Hydrocephalus etiology   surgery   MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Neuroendoscopy methods   MeSH
• Syndrome MeSH
• Third Ventricle abnormalities   surgery   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

OBJECTIVE: Based on the clinical observation that patients suffering from narcolepsy with cataplexy (NC) have cataplectic attacks when they experience positive emotions, it is therefore hypothesised that the abnormal processing of external emotional input through the limbic system, or motor dysregulation induced by emotions, takes place during these episodes. To date, imaging studies have failed to reveal consistent brain abnormalities in NC patients. METHODS: Considering the discrepancies in reported structural or functional abnormalities of the hypothalamus, amygdala, and nucleus accumbens, we used the MRI volumetry to determine the volumes of the amygdala and nucleus accumbens in a group of eleven patients with NC (5 males and 6 females, mean age 41.7 years ± 17.7). This data was compared to an equal number of examinations in healthy volunteers matched for age and gender. RESULTS: We found a decrease in the amygdalar volume of NC patients in both raw (p<0.001) and relative (p<0.01) data sets. The difference in amygdalar volume between healthy volunteers and NC patients was about 17%. In contrast to the amygdala, we did not find any differences in the volumes of nucleus accumbens. CONCLUSION: In the present MRI volumetric study, we found bilateral gray matter loss in the amygdala only.

• MeSH
• Amygdala pathology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   standards   MeSH
• Young Adult MeSH
• Narcolepsy pathology   MeSH
• Nucleus Accumbens anatomy & histology   MeSH
• Reproducibility of Results MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

PURPOSE: Our aim was to determine whether the anatomical configuration of the posterior fossa and its substructures might represent a predisposition factor for the occurrence of clinical neurovascular conflict in trigeminal neuralgia (TN). METHODS: We used MRI volumetry in 18 patients with TN and 15 controls. The volume of the pontomesencephalic cistern, Meckel's cave and the trigeminal nerve on the clinical and non-affected sides was compared. The reliability has been assessed in all measurements. RESULTS: The posterior fossa volume was not different in the clinical and control groups; there was no difference between the affected and non-affected sides when measuring the pontomesencephalic cistern and Meckel's cave volume either. The volume of the clinically affected trigeminal nerve was significantly reduced, but with a higher error of measurement. CONCLUSIONS: We did not find any association between the clinical neurovascular conflict (NVC) and the size of the posterior fossa and its substructures. MRI volumetry may show the atrophy of the affected trigeminal nerve in clinical NVC.

• MeSH
• Anthropometry methods   MeSH
• Basilar Artery physiopathology   pathology   MeSH
• Atrophy etiology   physiopathology   pathology   MeSH
• Adult MeSH
• Causality MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Trigeminal Nerve pathology   MeSH
• Trigeminal Neuralgia etiology   physiopathology   pathology   MeSH
• Image Processing, Computer-Assisted methods   MeSH
• Predictive Value of Tests MeSH
• Aged MeSH
• Cranial Fossa, Middle abnormalities   pathology   MeSH
• Cranial Fossa, Posterior abnormalities   pathology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Validation Study MeSH