Syndrom reverzibilní encefalopatie v zadní cirkulaci (PRES) je vzácným patologickým stavem, pro jehož diagnostiku mají zásadní význam zobrazovací metody, zejména pak magnetická rezonance, které umožní detekovat pro toto onemocnění typicky distribuované zóny vazogenního edému mozku. Vznik PRES je spojován s řadou rizikových faktorů. Kazuistika popisuje PRES u 46leté ženy, léčené v minulosti pro akutní myeloidní leukemii s četnými průvodními komplikacemi. Klinické projevy PRES většinou vznikají náhle a zahrnují řadu neurologických příznaků. Častá bývá přítomnost nekorigované hypertenzní nemoci. Léčba PRES je principiálně založena na ovlivnění základního onemocnění. Ačkoliv je obecně prognóza PRES považována za dobrou, nemusí dojít k plné úpravě zdravotního stavu a onemocnění může také skončit fatálně.

Posterior reversible encephalopathy syndrome (PRES) is a rare pathological entity, in which the neuroimaging, especially MRI, is essential for the diagnosis. The disease is characterized by the typical distribution of cerebral vasogenic edema. Several risk factors are known to be associated with the PRES development. This case report describes PRES in a 46-year-old woman treated in the past for acute myeloid leukemia with numerous concomitant complications. The clinical manifestations of PRES is usually sudden and include a various neurological symptoms. The presence of uncontrolled hypertensive disease is a frequent finding. The treatment of PRES usually focusses on the underlying disease. Although the prognosis of the PRES is generally considered to be favorable, the disease may not be completely reversible and may also be fatal.

• MeSH
• Diagnosis, Differential MeSH
• Brain Edema diagnostic imaging   etiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Risk Factors MeSH
• Posterior Leukoencephalopathy Syndrome * diagnostic imaging   etiology   pathology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

The case report presents the case of a five-year-old boy who fell off a scooter and sustained a blow to the left temporal region of his head. During a CT examination in the district hospital he suddenly showed a deterioration in the level of consciousness. Subsequent treatment along with transport to a specialized department were aimed at preventing secondary pathological changes and maintaining pressure-volume homeostasis of the brain. High-quality controlled ventilation with effective pharmacotherapy and gentle transport were essential. At the target specialized department, cerebral oedema in the left temporal region and aspiration in the right upper lung lobe were identified. The boy was extubated after 6 hours of controlled ventilation and discharged to an intermediate care bed two days later without any serious consequences. Key words: cerebral oedema, haemodynamic swelling, severe head injury.

• MeSH
• Brain Edema * diagnostic imaging   etiology   therapy   MeSH
• Craniocerebral Trauma * complications   therapy   MeSH
• Humans MeSH
• Brain MeSH
• Child, Preschool MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

Brain edema is a fatal pathological state in which brain volume increases as a result of abnormal accumulation of fluid within the brain parenchyma. A key attribute of experimentally induced brain edema - increased brain water content (BWC) - needs to be verified. Various methods are used for this purpose: specific gravimetric technique, electron microscopic examination, magnetic resonance imaging (MRI) and dry/wet weight measurement. In this study, the cohort of 40 rats was divided into one control group (CG) and four experimental groups with 8 rats in each group. The procedure for determining BWC using dry/wet weight measurement was initiated 24 h after the completion of edema induction by the water intoxication method (WI group); after the intraperitoneal administration of Methylprednisolone (MP) together with distilled water during edema induction (WI+MP group); 30 min after osmotic blood brain barrier disruption (BBBd group); after injection of MP via the internal carotid artery immediately after BBBd (BBBd + MP group). While induction of brain edema (WI, BBBd) resulted in significantly higher BWC, there was no increase in BWC in the MP groups (WI+MP, BBBd+MP), suggesting a neuroprotective effect of MP in the development of brain edema.

• MeSH
• Brain Edema * chemically induced   diagnostic imaging   pathology   MeSH
• Edema pathology   MeSH
• Blood-Brain Barrier MeSH
• Rats MeSH
• Methylprednisolone pharmacology   MeSH
• Brain MeSH
• Water MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Cytotoxické léze corpus callosum (cytotoxic lesions of the corpus callosum; CLOCCs) reprezentují skupinu stavů, které způsobují změny intenzity signálu v corpus callosum na MR. Etiologie tohoto jevu je velmi heterogenní. CLOCCs jsou asociovány se spektrem metabolických chorob, lékovou terapií, infekcemi, epileptickými záchvaty a mnoha jinými příčinami. Zdá se, že tyto léze jsou důsledkem stereotypní zánětlivé kaskády, která vede k masivnímu zvýšení hladin extracelulárního glutamátu. Konečným výsledkem je rozvoj cytotoxického edému. Škála klinických projevů je velmi rozmanitá. Neurologické symptomy zahrnují postižení hybnosti a/nebo citlivosti, kognitivní deficit, změny chování, závratě, poruchu vědomí a další. Hlavní diagnostickou metodou je MR, především difuzívážené zobrazení, na kterém se CLOCCs manifestují jako oblasti s restrikcí difuze. CLOCCs jsou ve většině případů reverzibilní. Prognóza a léčba obvykle závisí na etiologii, ale výsledný klinický stav bývá příznivý. Lékaři by měli být s touto nedávnou pojmenovanou diagnózou obeznámeni, především proto, že většina vyvolávajících příčin je léčitelná. V tomto sdělení shrnujeme dosavadní poznatky a prezentujeme pět případů CLOCCs.

Cytotoxic lesions of the corpus callosum (CLOCCs) represent a group of conditions that cause MRI signal intensity changes in the corpus callosum. Etiology of this phenomenon is very heterogenous. CLOCCs are associated with a spectrum of metabolic disorders, drug therapy, infections, epileptic seizures and many other causes. It appears that these lesions result from a stereotyped inflammatory cascade which leads to a massive increase in levels of extracellular glutamate. The final result is development of cytotoxic edema. The range of clinical features is very wide. Neurological symptoms include motor and/or sensory involvement, cognitive decline, behavioral changes, dizziness, loss of consciousness and others. The main diagnostic tool is MRI, especially diffusion-weighted images, where CLOCCs manifest as regions of restricted diffusion. CLOCCs are reversible in most cases. Prognosis and treatment generally depend on the etiology, but clinical outcome is usually favorable. Physicians should be familiar with this recently named diagnosis, primarily because most of the underlying causes are treatable. In this article, we summarize the current knowledge and describe five cases of CLOCCs.

• Keywords
• restrikce difuze, reverzibilní léze,
• MeSH
• Corpus Callosum * diagnostic imaging   pathology   MeSH
• Brain Edema diagnostic imaging   etiology   pathology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Magnetic resonance imaging has been used for evaluating of a brain edema in experimental animals to assess cytotoxic and vasogenic edema by the apparent diffusion coefficient (ADC) and T2 imaging. This paper brings information about the effectiveness of methylprednisolone (MP) on experimental brain edema. A total of 24 rats were divided into three groups of 8 animals each. Rats with cytotoxic/intracellular brain edema induced by water intoxication were assigned to the group WI. These rats also served as the additional control group CG when measured before the induction of edema. A third group (WIMP) was intraperitoneally administered with methylprednisolone 100 mg/kg during water intoxication treatment. The group WI+MP was injected with methylprednisolone 50 mg/kg into the carotid artery within two hours after the water intoxication treatment. We evaluated the results in four groups. Two control groups (CG, WI) and two experimental groups (WIMP, WI+MP). Rats were subjected to MR scanning 24 h after edema induction. We observed significantly increased ADC values in group WI in both evaluated areas - cortex and hippocampus, which proved the occurrence of experimental vasogenic edema, while ADC values in groups WIMP and WI+MP were not increased, indicating that the experimental edema was not developed and thus confirming the protective effect of MP.

• MeSH
• Anti-Inflammatory Agents pharmacology   MeSH
• Brain Edema diagnostic imaging   drug therapy   pathology   MeSH
• Hippocampus diagnostic imaging   drug effects   MeSH
• Rats MeSH
• Magnetic Resonance Imaging methods   MeSH
• Methylprednisolone pharmacology   MeSH
• Disease Models, Animal MeSH
• Brain diagnostic imaging   drug effects   MeSH
• Cerebral Cortex diagnostic imaging   drug effects   MeSH
• Rats, Wistar MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Male MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

• Keywords
• areflexie,
• MeSH
• Unconsciousness MeSH
• Brain Edema surgery   diagnostic imaging   MeSH
• Fatal Outcome MeSH
• Humans MeSH
• Brain diagnostic imaging   pathology   MeSH
• Brain Death * diagnostic imaging   physiopathology   MeSH
• Tissue and Organ Harvesting MeSH
• Hematoma, Subdural surgery   diagnostic imaging   MeSH
• Accidental Falls MeSH
• Check Tag
• Humans MeSH
• Publication type
• Case Reports MeSH
• Review MeSH

• MeSH
• Brain Edema surgery   diagnostic imaging   MeSH
• Hematoma, Epidural, Cranial surgery   diagnosis   MeSH
• Hemodynamic Monitoring methods   MeSH
• Intracranial Hypertension * etiology   complications   physiopathology   therapy   MeSH
• Brain Ischemia etiology   MeSH
• Craniocerebral Trauma therapy   MeSH
• Craniotomy MeSH
• Humans MeSH
• Brain diagnostic imaging   pathology   MeSH
• Cerebrovascular Circulation MeSH
• Disease Progression MeSH
• Aged MeSH
• Thiopental adverse effects   therapeutic use   MeSH
• Tomography, Emission-Computed MeSH
• Accidental Falls MeSH
• Pneumonia, Ventilator-Associated etiology   MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Publication type
• Case Reports MeSH
• Review MeSH

• MeSH
• Biocompatible Materials therapeutic use   MeSH
• Brain Edema * surgery   diagnostic imaging   pathology   therapy   MeSH
• Skull Fractures surgery   diagnostic imaging   pathology   therapy   MeSH
• Image Interpretation, Computer-Assisted MeSH
• Infant MeSH
• Brain Contusion * surgery   diagnostic imaging   pathology   therapy   MeSH
• Humans MeSH
• Meninges surgery   MeSH
• Neurosurgical Procedures MeSH
• Prostheses and Implants MeSH
• Radiography MeSH
• Accidents MeSH
• Treatment Outcome MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

• Keywords
• fungus cerebri, kranioplastika, postischemické změny, reosifikace, defekty lebky,
• MeSH
• Unconsciousness etiology   MeSH
• Brain Edema * surgery   diagnostic imaging   therapy   MeSH
• Epilepsy etiology   MeSH
• Durapatite therapeutic use   MeSH
• Image Interpretation, Computer-Assisted MeSH
• Intracranial Hemorrhages therapy   MeSH
• Hematoma, Subdural, Intracranial * surgery   diagnostic imaging   therapy   MeSH
• Intracranial Pressure MeSH
• Infant MeSH
• Craniotomy MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Meninges surgery   MeSH
• Neurosurgical Procedures methods   adverse effects   MeSH
• Paresis etiology   MeSH
• Prostheses and Implants MeSH
• Treatment Outcome MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Anticoagulants therapeutic use   MeSH
• Anticonvulsants therapeutic use   MeSH
• Biocompatible Materials therapeutic use   MeSH
• Brain Edema surgery   diagnostic imaging   drug therapy   MeSH
• Glasgow Coma Scale MeSH
• Image Interpretation, Computer-Assisted MeSH
• Infant MeSH
• Craniotomy MeSH
• Hemorrhage therapy   MeSH
• Lacerations MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Meninges surgery   MeSH
• Neurosurgical Procedures MeSH
• Cranial Sinuses surgery   diagnostic imaging   injuries   MeSH
• Hematoma, Subdural * surgery   diagnostic imaging   etiology   drug therapy   mortality   pathology   therapy   MeSH
• Accidental Falls MeSH
• Treatment Outcome MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH