We tried to establish possible correlations between clinical data and MRI in a group of patients with Wilson's disease. Eleven patients (6 male, 5 female), aged between 11 and 50 years old, with a duration of illness from 5 months to 32 years, were submitted to MRI on a 1.5 T System. Three patients were asymptomatic, two had mild neurological disturbances, two were moderately affected and the remaining four had a severe form of the disease. All were receiving D-penicillamine at the time of the study. In the most symptomatic patients there were abnormalities in five or more sites on MRI. The putamen was affected in all symptomatic patients, including five with dystonia. A striking feature was the peripheral location of high signal putaminal lesions on T2-weighted images. In five cases, lesions in the corpus striatum or substantia nigra explained the patient's Parkinsonian features. MRI is an efficient method for studying involvement of the central nervous system in Wilson's disease, and allows some interesting anatomoclinical correlations.

SummarySeveral recent studies have analyzed a possible effect of thrombophilia risk factors such as factor V Leiden, the prothrombin variant (allele 20210 A), and homozygosity for thermolabile methylenetetrahydrofolate reductase (MTHFR-T) on the development of ischemic stroke (IS). In the present study, we determined the role of these prothrombotic polymorphisms in the early onset of arterial IS or cerebral venous thrombosis (CVT) in a group of young Brazilian adults of Caucasian and African descent.We conducted a cross-sectional study of 167 survivors of IS (153 patients with arterial IS and 14 cases of CVT; 66 men: 101 women; 124 of Caucasian and 43 of African origin; median age: 32.6 years; range: 15 to 45 years) and compared the prevalence of inherited thrombophilia risk factors with a control group of 225 sex and age matched individuals of the same ethnic background. To determine the interaction with atherogenic risk factors, the following diagnoses were considered: hypertension, hyperlipoproteinemia, diabetes mellitus, smoking status and use of oral contraceptives.In the arterial IS group, no significant variation was found between patients and controls of Caucasian origin regarding the prevalence of factor V Leiden (P = 0.92), the prothrombin variant (P = 0.13) or homozygosity for MTHFR-T (P = 0.61). Among Brazilians of African descent, 10.3%were homozygous for MTHFR-T, which was significantly elevated, odds ratio of 5.9 (95%CI: 0.88 to 49.15). In the CVT group, two Caucasian patients (20%) were heterozygous for the prothrombin variant, odds ratio of 9.7 (95%CI: 0.95 to 89.71) and one patient was carrier of factor V Leiden (P = 0.49). No prothrombotic polymorphism was identified in patients with CVT of African descent. All women in the CVT group were in use of oral contraceptives or in the post-partum stateInherited thrombophilia risk factors were not found to increase the risk of arterial IS among young patients of Caucasian descent. However, a potential role of homozygosity for MTHFR-T was observed in a small group of patients of African origin. The analysis of patients with CVT revealed an increased risk due to the prothrombin gene variant or oral contraceptive use. Further studies including all incoming patients with IS are necessary to evaluate the impact of inherited thrombophilia risk factors on early mortality.

BACKGROUND AND PURPOSE:There are few studies comparing the capacity of lesion detection of conventional MR imaging in neurocysticercosis (NCC). This study was designed to clarify its role in the evaluation of this disease, focusing on the total number of lesions identified and the characterization of the scolex.

This 54-year-old man accidentally sprayed himself with the chemical agent glyphosate, a herbicide derived from the amino acid glycine. He developed disseminated skin lesions 6 hours after the accident. One month later, he developed a symmetrical parkinsonian syndrome. Two years after the initial exposure to glyphosate, magnetic resonance imaging revealed hyperintense signal in the globus pallidus and substantia nigra, bilaterally, on T2-weighted images. Levodopa/benserazide 500/125 mg daily provided satisfactory clinical outcome.

SUMMARY -Three hundred land fifty seven computed tomography (CT) from 100 different patients with neurocysticercosis (NC) were studied between 1979 and 1988. All patients were treated with praziquantel (PZQ).A new classification attempting to recognize the CT evolution profile in NC as well as assigning a possible link between CT findings and biological conditions of cysts is evaluated.It was possible to conclude that: intact cysts remain unchanged in consecutive CTs by 11 months and exhibit signs of degeneration in about 18 months after PZQ drug therapy; degenerating cysts can be detected by 10.5 months, disappear in 11 months and become nodular calcifications in about 25 months.Therefore, a time period of at least 36 months can be estimated for the complete evolution profile of cysts in the brain parenchyma.Tomografia computadorizada na neurocisticercose: análise da evolução em 100 pacientes durante 10 anos e avaliação de nova classificação. RESUMO -Foram estudados 357 exames por tomografia computadorizada do crânio (TC)de 100 pacientes com neurocisticercose, tratados com praziquantel (PZQ) entre 1979 e 1988. Foi utilizada nova classificação tomográfica, procurando estabelecer vincule entre as imagens observadas à TC e a evolução biológica dos cisticercos.Considerando-se como estimador o valor das medianas em meses após o tratamento com PZQ, foi possível concluir que: vesículas íntegras permanecem inalteradas em exames consecutivos por período de 11 meses; apresentam sinais radiológicos sugestivos de processo inflamatório, geralmente associados à degene¬ ração de cisticercos, em período de 1S meses; estas vesículas em degenerarão podem ser detectadas durante 10,5 meses, desaparecem em 11 meses e evoluem para calcificações nodu¬ lares simples em 25 meses. De acordo com este critério, pode ser estimado período mínimo de 36 meses para o perfil de evolução de cisticercos no parênquima cerebral em pacientes tratados com PZQ.Advances in the study of neurocysticercosis (NC) have been favoured in the last decade by the current use of computed tomography brain scan (CT). Cysts and calcifications were recognized as the two most common and important types of CT images suggesting the presence of the cysticerci in the brain parenchyma 9.In this same period drug therapy for the aetilogical agent through praziquantel (PZQ) has been introduced, favouring interest on the study of CT images in NC. In fact, comparison among CT images before and after PZQ therapy has been often referred to evaluate the effectiveness of the drug 6,12,14.However, such an interpretation may be hazardous since it is possible to admit that the disappearance of cysts might not be