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High-resolution nuclear magnetic resonance imaging and single photon emission computerized tomography--cerebral blood flow in a case of pure sensory stroke and mild dementia owing to subcortical arteriosclerotic encephalopathy (Binswanger's disease).
Am J Physiol Imaging. 1987; 2(4):192-5.AJ

Abstract

Pure sensory stroke (PSS) is typically caused by a lacunar infarct located in the ventral-posterior (VP) thalamic nucleus contralateral to the paresthetic symptoms. The lesion is usually so small that it cannot be seen on computerized tomography (CT), as illustrated by our case. In our moderately hypertensive, 72-year-old patient with PSS, CT scanning and conventional nuclear magnetic resonance imaging (NMRI) scanning using a 7-mm-thick slice on a 1.5 Tesla instrument all failed to visualize the thalamic infarct. Using the high-resolution mode with 2-mm slice thickness it was, however, clearly seen. In addition, NMRI unexpectedly showed diffuse periventricular demyelinization as well as three other lacunar infarcts, i.e., findings characteristic of subcortical arteriosclerotic encephalopathy (SAE). This prompted psychometric testing, which revealed signs of mild (subclinical) dementia, in particular involving visiospatial apraxia; this pointed to decreased function of the right parietal cortex, which was structurally intact on CT and NMRI. Single photon emission computerized tomography by Xenon-133 injection and by hexamethyl-propyleneamine-oxim labeled with Technetium-99m showed asymmetric distribution of cerebral blood flow (CBF), with an 18% lower value in the right parietal cortex compared to the left side; this indicated asymmetric disconnection of the cortex by the SAE. Thus, the tomograms of the functional parameter, CBF, correlated better with the deficits revealed by neuropsychological testing than by CT or NMRI.

Authors+Show Affiliations

Department of Clinical Physiology/Nuclear Medicine, Bispebjerg Hospital, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

3502532

Citation

De Chiara, S, et al. "High-resolution Nuclear Magnetic Resonance Imaging and Single Photon Emission Computerized Tomography--cerebral Blood Flow in a Case of Pure Sensory Stroke and Mild Dementia Owing to Subcortical Arteriosclerotic Encephalopathy (Binswanger's Disease)." American Journal of Physiologic Imaging, vol. 2, no. 4, 1987, pp. 192-5.
De Chiara S, Lassen NA, Andersen AR, et al. High-resolution nuclear magnetic resonance imaging and single photon emission computerized tomography--cerebral blood flow in a case of pure sensory stroke and mild dementia owing to subcortical arteriosclerotic encephalopathy (Binswanger's disease). Am J Physiol Imaging. 1987;2(4):192-5.
De Chiara, S., Lassen, N. A., Andersen, A. R., Gade, A., Lester, J., Thomsen, C., & Henriksen, O. (1987). High-resolution nuclear magnetic resonance imaging and single photon emission computerized tomography--cerebral blood flow in a case of pure sensory stroke and mild dementia owing to subcortical arteriosclerotic encephalopathy (Binswanger's disease). American Journal of Physiologic Imaging, 2(4), 192-5.
De Chiara S, et al. High-resolution Nuclear Magnetic Resonance Imaging and Single Photon Emission Computerized Tomography--cerebral Blood Flow in a Case of Pure Sensory Stroke and Mild Dementia Owing to Subcortical Arteriosclerotic Encephalopathy (Binswanger's Disease). Am J Physiol Imaging. 1987;2(4):192-5. PubMed PMID: 3502532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-resolution nuclear magnetic resonance imaging and single photon emission computerized tomography--cerebral blood flow in a case of pure sensory stroke and mild dementia owing to subcortical arteriosclerotic encephalopathy (Binswanger's disease). AU - De Chiara,S, AU - Lassen,N A, AU - Andersen,A R, AU - Gade,A, AU - Lester,J, AU - Thomsen,C, AU - Henriksen,O, PY - 1987/1/1/pubmed PY - 1987/1/1/medline PY - 1987/1/1/entrez SP - 192 EP - 5 JF - American journal of physiologic imaging JO - Am J Physiol Imaging VL - 2 IS - 4 N2 - Pure sensory stroke (PSS) is typically caused by a lacunar infarct located in the ventral-posterior (VP) thalamic nucleus contralateral to the paresthetic symptoms. The lesion is usually so small that it cannot be seen on computerized tomography (CT), as illustrated by our case. In our moderately hypertensive, 72-year-old patient with PSS, CT scanning and conventional nuclear magnetic resonance imaging (NMRI) scanning using a 7-mm-thick slice on a 1.5 Tesla instrument all failed to visualize the thalamic infarct. Using the high-resolution mode with 2-mm slice thickness it was, however, clearly seen. In addition, NMRI unexpectedly showed diffuse periventricular demyelinization as well as three other lacunar infarcts, i.e., findings characteristic of subcortical arteriosclerotic encephalopathy (SAE). This prompted psychometric testing, which revealed signs of mild (subclinical) dementia, in particular involving visiospatial apraxia; this pointed to decreased function of the right parietal cortex, which was structurally intact on CT and NMRI. Single photon emission computerized tomography by Xenon-133 injection and by hexamethyl-propyleneamine-oxim labeled with Technetium-99m showed asymmetric distribution of cerebral blood flow (CBF), with an 18% lower value in the right parietal cortex compared to the left side; this indicated asymmetric disconnection of the cortex by the SAE. Thus, the tomograms of the functional parameter, CBF, correlated better with the deficits revealed by neuropsychological testing than by CT or NMRI. SN - 0885-8276 UR - https://www.unboundmedicine.com/medline/citation/3502532/High_resolution_nuclear_magnetic_resonance_imaging_and_single_photon_emission_computerized_tomography__cerebral_blood_flow_in_a_case_of_pure_sensory_stroke_and_mild_dementia_owing_to_subcortical_arteriosclerotic_encephalopathy__Binswanger's_disease__ L2 - http://www.diseaseinfosearch.org/result/844 DB - PRIME DP - Unbound Medicine ER -