Search Results (15)

Background and Clinical Significance: Cavum septum pellucidum (CSP) and cavum vergae (CV) are anatomical variations that may persist into childhood, adolescence, or adulthood. When these cavities become abnormally large, they are classified as cysts. The mechanism leading to expansion is poorly understood. Although rare, symptomatic CSP and CV cysts can present with a wide range of clinical manifestations. Case Presentation: A 20-year-old Caucasian male presented with progressively worsening symptoms over several months including persistent headaches and dizziness. Neurological evaluation showed no abnormalities, with intact cranial nerve function, normal muscle strength, and no signs of paresis. Imaging identified CSP and CV cysts causing obstructive hydrocephalus. MRI findings confirmed progressive cyst enlargement and obstruction of intraventricular foramen. The patient underwent neuroendoscopic fenestration of the cyst with resolution of both hydrocephalus and the symptoms. A CT and MRI scan of the brain performed 12 years before revealed a developmental variant, showing no evidence of cyst formation or ventricular enlargement and without hydrocephalus at that time. This case provides a rare opportunity to observe cyst growth dynamics over time. Conclusions: This case presents the importance of recognizing symptomatic CSP and CV cysts as rare but significant causes of obstructive hydrocephalus. The progression from a developmental variant to cyst formation over time illustrates the value of long-term imaging follow-up in such cases. Neuroendoscopic fenestration provided complete resolution of symptoms, demonstrating the effectiveness of surgical intervention in such cases. Full article

Background: Midline cysts of the brain are comprised of the following entities, septum pellucidum cysts, cavum vergae cysts and velum interpositum cysts. These lesions are uncommon and often asymptomatic; nonetheless, certain clinical manifestations may be linked to midline cysts, including headaches, signs of elevated intracranial pressure, neurological deficits, or alterations in mental status. Controversy persists in the therapy of symptomatic cases, mostly due to the challenge of establishing a correlation between the symptomatology and the presence of the cyst. Case description: We present the case of a 64-year-old female known with type—1 neurofibromatosis that associated a midline cyst. The cyst was treated endoscopically, in the initial stage (single wall perforation) showed no clinical or imagistic improvement. The incriminated symptoms in these cases are caused not only by compression or obstruction of the CSF flow but also to a complex alteration of CSF dynamics, in this case the stoma was found permeable at the second surgery but there was no obvious communication on the preoperative evaluation by ventriculocisternostomy. A second surgery was performed, with bilateral perforation and subsequent improvement of symptomatology and decrease of cyst dimensions. A literature review is presented concerning clinical presentation, therapeutic options, and possible outcomes. Conclusions: Endoscopic fenestration is an efficacious method for treating midline cysts, with bilateral wall fenestration representing the standard practice. Understanding the anatomical and developmental specifics of the septal region, together with cerebrospinal fluid dynamics, is essential for effective treatment of this condition. Full article

Background/Objectives: Maternal thyroid function plays a crucial role in fetal brain development, yet the potential impact of maternal hypothyroidism and thyroid autoimmunity on fetal intracranial structures remains inadequately explored. To investigate the impact of maternal hypothyroidism and thyroid autoimmunity on fetal intracranial structures, focusing on potential alterations in critical brain parameters during mid-gestation. Methods: This prospective case-control study included pregnant women between 18 and 24 weeks of gestation. Participants were divided into three groups: hypothyroidism and antibodies (Ab) group, hypothyroidism and Ab(–) group, and the control group. Ultrasonographic measurements of fetal intracranial structures such as the posterior lateral ventricle (PLV), cavum septum pellucidi (CSP), cisterna magna (CM), thalamus, and transcerebellar diameter (TCD) were recorded and compared. Results: A total of 153 pregnant women were evaluated (n = 52 in the hypothyroidism and Ab(+) group, n = 51 in the hypothyroidism and Ab(−) group, and n = 50 in the control group). Although most of the biometric parameters were similar across the groups, the hypothyroidism and Ab(+) group exhibited significantly lower PLV and thalamus measurements compared to the control group (p < 0.05). Additionally, there was a notable difference in the BMI among the groups, with hypothyroid participants (with or without antibodies) showing higher rates of being overweight or obese. Conclusions: Maternal hypothyroidism and the presence of thyroid autoantibodies may be associated with subtle changes in fetal brain structures during the mid-gestation period, particularly in the thalamus and PLV. Full article

Gestational diabetes mellitus (GDM) is a prevalent medical complication in pregnancy that is rapidly escalating worldwide, with epidemic implications. This systematic review aims to identify fetal brain changes using neurosonography and pinpoint potential markers for the early diagnosis of GDM. We conducted a literature search from 6 January 2013 to 4 September 2024 to identify studies examining fetal brain development using ultrasound in pregnancies affected by GDM compared to uncomplicated pregnancies. The outcome measures included the cavum septum pellucidum (CSP), corpus callosum (CC), lateral ventricle (LV), cisterna magna (CM), transcerebellar diameter (TCD), cerebral fissures (CF), and others. For pregnancies affected by GDM, results were reported. Five studies were included. The findings suggest that the width of the CSP was larger in fetuses of mothers with GDM compared to the control group, and the mean widths of LVs were also larger in the fetuses of diabetic mothers compared to the control group. The influence of GDM on fetal brain development as assessed by neurosonography necessitates thorough investigation in future studies. Full article

Ear image segmentation and identification is for the “observation” of TCM (traditional Chinese medicine), because disease diagnoses and treatment are achieved through the massaging of or pressing on some corresponding ear acupoints. With the image processing of ear image positioning and regional segmentation, the diagnosis and treatment of intelligent traditional Chinese medicine ear acupoints is improved. In order to popularize ear acupoint therapy, image processing technology has been adopted to detect the ear acupoint areas and help to gradually replace well-trained, experienced doctors. Due to the small area of the ear and the numerous ear acupoints, it is difficult to locate these acupoints based on traditional image recognition methods. An AAM (active appearance model)-based method for ear acupoint segmentation was proposed. The segmentation was illustrated as 91 feature points of a human ear image. In this process, the recognition effects of the ear acupoints, including the helix, antihelix, cymba conchae, cavum conchae, fossae helicis, fossae triangularis auriculae, tragus, antitragus, and earlobe, were divided precisely. Besides these, specially appointed acupoints or acupoint areas could be prominent in ear images. This method made it possible to partition and recognize the ear’s acupoints through computer image processing, and maybe own the same abilities as experienced doctors for observation. The method was proved to be effective and accurate in experiments and can be used for the intelligent diagnosis of diseases. Full article

The aim of the study was to evaluate factors that may contribute to the persistence of positive, negative and other psychopathological symptoms of schizophrenia. All patients were treated in general psychiatric wards between January 2006 and December 2017. The initial study sample comprised of the medical reports of 600 patients. The main, specified inclusion criterion for the study was schizophrenia as a discharge diagnosis. Medical reports of 262 patients were excluded from the study due to no neuroimaging scans being available. The symptoms were categorised into three groups: positive, negative, and other psychopathological symptoms. The statistical analysis comprised modalities such as demographic data, clinical symptoms, as well as neuroimaging scans linking them to a potential impact of sustaining the mentioned groups of symptoms during the period of hospitalization. The analysis revealed that statistically significant risk factors of persistence of the three groups of symptoms are the elderly age, the increasing toll of hospitalizations, suicidal attempts in medical history, a family history of alcohol abuse, the presence of positive, negative and other psychopathological symptoms on admission to the hospital, as well as the absence of cavum septi pellucidi (CSP). The study showed that addiction to psychotropic drugs and a family history of schizophrenia were more frequent in patients with persistent CSP. Full article

How many patients with psychosis secondary to genetic conditions or congenital brain malformation have been diagnosed with schizophrenia, since its initial conception more than one hundred years ago? A case report of a young man, with antecedents of Capgras and Cotard syndromes, sent to a schizophrenia treatment-resistant outpatient clinic is presented. Instead of true, primary, idiopathic schizophrenia, a diagnosis of secondary schizophrenia (pseudo-schizophrenia or schizophrenia-like psychosis) was made, corresponding to a secondary psychotic syndrome, with hallucinations and delusions due to congenital cavum septi pellucidi, cavum vergae, cavum veli interpositi and progressive brain atrophy due to cystinosis. Extreme caution is recommended when diagnosing schizophrenia in severely psychotic patients independent of their acute or chronic condition. Schizophrenia shall never be forgotten as the great imitated of medicine. Full article

The aims of this study were to assess the common anomalies in the MRI examinations of the heads of soldiers as well as to compare the relative concentration of magnetic resonance spectroscopy (MRS) metabolites in the brains of soldiers with those of healthy age-matched controls. Overall, 54 professional male soldiers were included in the study group and 46 healthy, age-matched males were in the control group. The relative values of N-acetylaspartate (NAA), choline (Cho), and myoinositol (mI) to creatine (Cr) were assessed. The mean relative concentrations of metabolites were compared between the study and the control group, separately for the frontal and occipital lobes, as well as between the right and left hemispheres within the study group only. The most frequent findings in the head MRI of the soldiers were: asymmetric lateral ventricles and dilated perivascular spaces, enlargement of the subarachnoid spaces, and the presence of cavum septum pellucidum and cavum vergae; the high frequency of sinus disease should also be noted. In the frontal lobes, the mI/Cr ratio was significantly higher (p = 0.005), while the NAA/Cr ratio was lower (p = 0.001), in the group of soldiers (vs. the study group). In the occipital lobes, the NAA/Cr ratio was significantly lower (p = 0.005) in the military personnel and there was a tendency to a higher mI/Cr ratio in the soldiers’ occipital lobes (p = 0.056) (vs. the study group). Comparing the metabolites between the left and right hemispheres in soldiers preferring a right shooting position, a significantly higher mI/Cr (p < 0.001) ratio was observed in the right frontal lobe (vs. the left) and a markedly lower NAA/Cr (p = 0.003) in the right occipital lobe (vs. the left). These changes are associated with astrogliosis and neuronal loss, presumably secondary to repetitive mild traumatic brain injury. Full article

Diagnosis of a chromosome 22q11.2 microdeletion and its associated deletion syndrome (22q11.2DS) is optimally made early. We reviewed the available literature to provide contemporary guidance and recommendations related to the prenatal period. Indications for prenatal diagnostic testing include a parent or child with the 22q11.2 microdeletion or suggestive prenatal screening results. Definitive diagnosis by genetic testing of chorionic villi or amniocytes using a chromosomal microarray will detect clinically relevant microdeletions. Screening options include noninvasive prenatal screening (NIPS) and imaging. The potential benefits and limitations of each screening method should be clearly conveyed. NIPS, a genetic option available from 10 weeks gestational age, has a 70–83% detection rate and a 40–50% PPV for most associated 22q11.2 microdeletions. Prenatal imaging, usually by ultrasound, can detect several physical features associated with 22q11.2DS. Findings vary, related to detection methods, gestational age, and relative specificity. Conotruncal cardiac anomalies are more strongly associated than skeletal, urinary tract, or other congenital anomalies such as thymic hypoplasia or cavum septi pellucidi dilatation. Among others, intrauterine growth restriction and polyhydramnios are additional associated, prenatally detectable signs. Preconception genetic counselling should be offered to males and females with 22q11.2DS, as there is a 50% risk of transmission in each pregnancy. A previous history of a de novo 22q11.2 microdeletion conveys a low risk of recurrence. Prenatal genetic counselling includes an offer of screening or diagnostic testing and discussion of results. The goal is to facilitate optimal perinatal care. Full article

Cavum septum pellucidum (CSP) is one of the most important physiologic structures that should be detected in Ultrasound (US) scanning for the normal development of the fetal central nervous system. However, manual measurement of CSP is still a difficult and time-consuming task due to the high noise of US images, even for experienced sonographers. Especially considering that maternal mortality remains high in many developing countries, a data-driven system with a medical diagnosis can help sonographers and obstetricians make decisions rapidly and improve their work efficiency. In this study, we propose a novel data-driven system based on deep learning for the diagnosis of CSP called CA-Unet, which consists of a channel attention network to segment the CSP and a post-processing module to measure and diagnose the anomalies of CSP. We collected the US data from three hospitals in China from 2012 to 2018 year to validate the effectiveness of our system. Experiments on a fetal US dataset demonstrated that our proposed system is able to help doctors make decisions and has achieved the highest precision of 79.5% and the largest Dice score of 77.5% in the segmentation of CSP. Full article

A new monoraphid diatom genus, Planoplatessa gen. nov., is described on the basis of a detailed morphological investigation using light and scanning electron microscopy. We transferred Achnanthes joursacensis Héribaud, a species described from fossil deposits in France, to our new genus. We investigated material from Mongolia from Recent populations. This taxon is known from fossils to Recent across the Holarctic. Achnanthes joursacensis was previously transferred to the genera Planothidium and Platessa, but the morphology of A. joursacensis does not share all morphological features with these two genera. We discuss important morphological features for the delimitation of monoraphid genera based on careful morphological and molecular investigations we presented previously. Planoplatessa gen. nov. as a genus is characterized by having uniseriate striae on both the raphe and the rapheless valves, a cavum in rapheless valves only, and straight distal raphe ends on the valve face. Full article

Fetal magnetic resonance imaging (MRI) has become a widely used tool in clinical practice, providing increased accuracy in prenatal diagnoses of congenital abnormalities of the brain, allowing for more accurate prenatal counseling, optimization of perinatal management, and in some cases fetal intervention. In this article, a brief description of how fetal ultrasound (US) and fetal MRI are used in clinical practice will be followed by an overview of the most common reasons for referral for fetal MRI of the brain, including ventriculomegaly, absence of the cavum septi pellucidi (CSP) and posterior fossa anomalies. Full article

The relationship between viral infections and cancer is well known and has been established for decades. Multiple tumours are generated from alterations secondary to viral infections 2 resulting from a dysregulation of the immune system in many cases. Certain causal relationships, such as that between the Epstein–Barr virus (EBV) in nasopharyngeal cancer or hepatitis C and B viruses in hepatocarcinoma, have been clearly established, and their implications for the prognosis and treatment of solid tumours are currently unknown. Multiple studies have evaluated the role that these infections may have in the treatment of solid tumours using immunotherapy. A possible relationship between viral infections and an increased response to immune checkpoint inhibitors (ICIs) has been established at a theoretical level in solid neoplasms, such as EBV-positive cavum cancer and human papillomavirus (HPV)-positive and oropharyngeal cancer. These could yield a greater response associated with the activation of the immune system secondary to viral infection, the consequence of which is an increase in survival in these patients. That is why the objective of this review is to assess the different studies or clinical trials carried out in patients with solid tumours secondary to viral infections and their relationship to the response to ICIs. Full article

Background: The outflow tract of crocodilians resembles that of birds and mammals as ventricular septation is complete. The arterial anatomy, however, presents with a pulmonary trunk originating from the right ventricular cavum, and two aortas originating from either the right or left ventricular cavity. Mixing of blood in crocodilians cannot occur at the ventricular level as in other reptiles but instead takes place at the aortic root level by a shunt, the foramen of Panizza, the opening of which is guarded by two facing semilunar leaflets of both bicuspid aortic valves. Methods: Developmental stages of Alligator mississipiensis, Crocodilus niloticus and Caiman latirostris were studied histologically. Results and Conclusions: The outflow tract septation complex can be divided into two components. The aorto-pulmonary septum divides the pulmonary trunk from both aortas, whereas the interaortic septum divides the systemic from the visceral aorta. Neural crest cells are most likely involved in the formation of both components. Remodeling of the endocardial cushions and both septa results in the formation of bicuspid valves in all three arterial trunks. The foramen of Panizza originates intracardially as a channel in the septal endocardial cushion. Full article

Current oxygen delivery modes lack monitoring and can be cumbersome for patients with chronic respiratory diseases. Integrating a pulse oximeter and nasal oxygen cannulas into eyeglasses would reduce the burden of current solutions. An ear pulse oximeter (OxyFrame) was evaluated on 16 healthy volunteers and 20 hypoxemic patients with chronic respiratory diseases undergoing a prespecified protocol simulating daily activities. Correlation, error, and accuracy root mean square error (A_RMS) were calculated to compare S_pO₂ measured by OxyFrame, a standard pulse oximeter (MASIMO), and arterial blood gas analysis (aBGA). S_pO₂ measured by OxyFrame and MASIMO correlated strongly in volunteers, with low error and high accuracy (r = 0.85, error = 0.2 ± 2.9%, A_RMS = 2.88%). Performances were similar in patients (r = 0.87, error 0 ± 2.5%, A_RMS = 2.49% compared with MASIMO; and r = 0.93, error = 0.4 ± 1.9%, A_RMS = 1.94% compared with aBGA). However, the percentage of rejected measurements was high (volunteers 77.2%, patients 46.9%). The OxyFrame cavum conchae pulse oximeter was successfully evaluated, and demonstrated accurate S_pO₂ measurements, compliant with ISO 80601-2-61:2017. Several reasons for the high rejection rate were identified, and potential solutions were proposed, which might be valuable for optimization of the sensor hardware. Full article