Hungarian Radiology

[Breast Imaging Day - Budapest, 4th April, 2008]

SIMON Éva

JUNE 22, 2008

Hungarian Radiology - 2008;82(03-04)

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Further articles in this publication

Hungarian Radiology

[Successful international course on the imaging diagnostics of the liver; ESGAR Liver Imaging Workshop - Szeged, 18th-20th April, 2008]

HARKÁNYI Zoltán

Hungarian Radiology

[Celebrating Professor Endre Kuhn on his 80th birthday]

WENINGER Csaba, HORVÁTH László

Hungarian Radiology

[Not ‘rounded-off’ birthday - Professor László Horváth, 71 years old]

LOMBAY Béla

Hungarian Radiology

[Significance of MR-angiographic technical parameters and the contrast material in the diagnosis of peripherial vascular diseases]

PAVLIKOVICS Gábor, SHAIKH Shoahib, FARAGÓ Katalin, LOMBAY Béla

[Atherosclerosis presents as a significant problem in everyday healthcare. Thus far, its effect on the vascular bed was measured by means of digital subtraction angiography. More recently, due to advance in hardware, the less invasive techniques like the ultrasound, CT and MRI have into the practice, producing results very similar to those of digital subtraction angiography. Recently, contrast material aimed for blood-pool MR angiography has been introduced. This change presents as a challenge to the operating personnel since the injection rate and the MR sequence parameters need to be adjusted adequately. Also, there is a late-phase breakdown of the contrast material. A further challenge is to interpret the steadystate images. In this article an effort has been made to summarise the basis of MR angiography, with special emphasis on peripheral angiography and suitable contrast materials. Finally, we illustrate our parameters through concrete cases.]

Hungarian Radiology

[16th French-Hungarian Radiological Symposium - Budapest, 16th-18th April, 2008]

– H. E. –

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We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

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The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. She experienced anomic aphasia and left-sided headache starting one day before admission. She had no trauma. A few minutes after admission she suddenly became comatose, her breathing became superficial. Non-contrast CT revealed left sided fronto-parietal subdural and subarachnoid and intracerebral haemorrhage, and bleeding was also observed in the right pontine region. The patient had leucocytosis and hyperglycemia but normal hemostasis. After the subdural haemorrhage had been evacuated, the patient was transferred to intensive care unit. Sepsis developed. Echocardiography did not detect endocarditis. Neurological status, vigilance gradually improved. The rehabilitation process was interrupted by epileptic status. Control CT and CT angiography proved an aneurysm in the peripheral part of the left middle cerebral artery, which was later clipped. Histolo­gical examination excluded mycotic etiology of the aneu­rysm and “normal aneurysm wall” was described. The brain stem haemorrhage – Duret bleeding – was presumably caused by a sudden increase in intracranial pressure due to the supratentorial space occupying process and consequential trans-tentorial herniation. This case is a rarity, as the patient not only survived, but lives an active life with some residual symptoms.

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