No abstract

This is the first report of acute Wernicke's encephalopathy in which characteristic magnetic resonance (MR) findings have been verified by postmortem histopathological examination. The high-signal areas surrounding the third and the fourth ventricles and the aqueduct on the T2-weighted images reflected the spongy disintegration of the neuropil, which is the typical pathological finding in Wernicke's encephalopathy. Weconfirmed that MRimaging is essential to the early diagnosis of Wernicke's encephalopathy. (Internal Medicine 35: 831-834, 1996)

Color-coded, cross-sectional imaging of local cerebral blood flow (LCBF) was made in a prospective manner among 22 patients with well-established common or classic migraine utilizing the stable xenon-enhanced computed tomographic (Xe CT-CBF) method. LCBF in patients during spontaneously occurring headaches (N = 12) were significantly higher compared to patients without headache (N = 10) by 25-35%. The hyperperfusion involved not only cerebral cortex but also subcortical structures including thalamus, basal ganglia, and subcortical white matter. LCBF increases were not bilateral and sometimes asymmetrical, but LCBF increases were not consistently related to the preponderant side of headache. No significant differences were observed in the degree or pattern of cerebral hyperperfusion during headaches compared among common (N = 6) and classic (N = 6) migraineurs. Results suggest a common etiology for both common and classic migraine. Results are not consistent with spreading oligemia or spreading cortical depression as a cause of migraine. The cerebral hyperperfusion appears to be mediated by various neurogenic and chemical changes accompanying migraine. The unilateral nature of migraine head pain is more likely due to dilation of extracranial vessels.

CT images ofleuko-araiosis in brain slices were quantified according to volumes of reduced Hounsfield units in frontal periventricular white matter in groups of elderly patients with multi-infarct dementia (MID, n = 23) and dementia of the Alzheimer type (DAT, n = 16). Volumes of leuko-araiosis, estimates of atrophic cerebral tissue, and local cerebral perfusion utilising inhalation of xenon gas as the indicator were correlated on the same CT slices. Ratios of frontal leuko-araiosis to total brain tissue volume were similar for patients with MID and DAT (mean 5-7 (SD 2'1)% v 6*5 (3.2%)), and both were significantly greater than ratios in elderly normal volunteers (31(13)%, 0 < 0.001). Cerebral atrophy (measured as the ratio of volumes of cerebrospinal fluid to total brain area) for DAT patients was 17-0 (6-7)%, which was greater than for MID patients (12-5 (5-4)%; p < 0.05) and both types of patients showed more cerebral atrophy than did age matched, elderly normal subjects.