Myoinositol (Myo) is a not yet well known metabolite detected using short echo time proton magnetic resonance spectroscopy (HMRS). We examined the role of Myo in 26 patients with new diagnosis of brain lesions including tumors, inflammatory and infectious processes. Histological confirmation of the diagnosis was obtained during gross total surgical resection or stereotactic biopsy of the lesions. The highest ratios of Myo/Cr were found in the hemangiopericytoma and meningioma followed by cortical dysplasia, low grade gliomas, gliobastomas, lymphomas, demyelinating lesions and toxoplasmosis. There was no Myo detected in the cases of metastasis and abscess. Increased Myo levels correlated with low grade gliomas suggesting its potential use in the differentiation of glial tumor. Myo demonstrated a unique pattern in hemangiopericytoma.
Progressive supranuclear palsy (PSP) also known as Steele, Richardson and Olszewski disorder (1-4) is a neurodegenerative brain disease that has no known cause, treatment or cure. PSP has no known geographical, occupational or racial preference and affects brain cells that control walking, balance, mobility, vision, speech and swallowing. Symptoms begin on average in the early 60s, but may start as early as in the 40s: a good history and physical examination support the clinical diagnosis and latency of each feature makes us suspect a probable PSP, an atypical Parkinsonism. The diagnosis of a large number of cases of PSP is missed or delayed: 75% of the patients are never clinically diagnosed by neurologist and in most cases the median interval between onset and diagnosis is three years. Notwithstanding such differences in clinical presentation, there remains an overlap in symptoms making the differential diagnosis between such neurodegenerative disorders challenging. A few imaging techniques developed to evaluate brain anatomy and function are used extensively to improve the diagnostic accuracy of different forms of Parkinsonism. Non-invasive and safe methods can now document brain structures. Transcranial sonography (TCS) is a very low cost tool to assess the basal ganglia and mesencephalic echogenicity (5,6). Conventional magnetic resonance imaging (MRI) is a valuable tool to exclude secondary Parkinsonism. Our purpose is to define characteristic objectively measured imaging markers that point out normal biological processes, and pathogenic processes in PSP. Such markers should be sufficiently sensitive and specific to show the underlying biological disease and the pharmacological responses to therapy.
RIASSUNTO -La duplicazione dell'ipofisi e una malformazione molto rara, che puo essere associata ad altre anomalie della linea mediana, del corpo callosa, dei vasi, dei bulbi oculari, delle ossa craniche e del midollo spinale.L'eziopatogenesi di questa malformazione e da ricercare all'interno delle anomalie di sviluppo embrionale che compaiono tra la 3° e 6° settimana di gestazione, quando lo sviluppo si trova compreso fra il 10° ed il 17o stadio embrionale.Vengono descritti due casi di duplicazione ipofisaria, uno associato ad agenesia dell'arteria carotide interna di destra, a meningocele sfenoidale e a coloboma dell'occhio di destra, l'altro, associato a meningocele sfenoidale, agenesia del corpo callosa e ad ispessimento della lamina terminalis. SUMMARY -Duplication of the pituitary gland is a rare malformation which may be associated with other abnormalities of the median line, corpus callosum, vessels, eyeball, cranial bones and spinal cord. The malformation originates among the abnormalities of embryologic development appearing between the third and sixth weeks of gestation when development is between the lOth and 17th embryologic stage.We describe two cases of hypophyseal duplication, one associated with agenesis of the right internal carotid artery, sphenoid meningocele and coloboma of the right eye, the other with sphenoid meningocele, agenesis of the corpus callosum and thickening of the lamina terminalis.
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