We report on a 56-year-old man who developed a rapidly progressive parkinsonism and apraxia over 2 months due to biopsy confirmed cerebral non-Hodgkin lymphoma primarily involving the SMA and parts of the superior frontal gyrus bilaterally.
Diffusion magnetic resonance imaging (MRI) has become an important tool in the radiologic diagnosis of diseases of the brain as it measures molecular motion of water that characterizes the microstructure of tissues. Its most important clinical use to date is the early detection of cerebral ischemia by revealing the ischemic injury shortly after vessel occlusion and simultaneously providing therapy-relevant information on the tissue at risk. Furthermore, diffusion MRI is diagnostically promising in other diseases of the brain and is thus increasingly becoming part of routine clinical protocols in the diagnosis of tumors, inflammation, trauma, demyelination, dysmyelination and neurodegeneration. Although abnormalities of diffusion are generally not pathognomonic, diffusion MRI affords information about tissue changes for specific disorders that complements information obtained with standard MR techniques and frequently shows pathology earlier. In addition, diffusion MRI can be applied to plan, guide and follow-up biopsies or resective surgery. Particularly diffusion tensor imaging (DTI), which displays the orientation of white matter fibers, holds promise for improved surgical planning. Moreover, DTI can be used to detect changes in connectivity between functional brain areas. Therefore, DTI is highly relevant not only in advancing the knowledge of white matter diseases but also in stimulating research on normal brain development and brain aging.
In Zeitraum von 1993-1994 wurden an der HNO-Klinik der TU MÜnchen 188 Patienten mit seit lÄnger als 6 Monaten bestehendem Tinnitus im Rahmen einer Tinnitussprechstunde betreut. Alle Patienten hatten vorher eine durchblutungsfÖrdernde Infusionstherapie erhalten, ohne dass subjektiv eine Beschwerdebesserung eingetreten ware. Es wird Über Altersverteilung, Tinnituscharakter, subjektiv empfundene Tinnituslautheit sowie Über Ursachen des Tinnitus bei dem Patientenkollektiv berichtet. Trotz der z.T. frÜher bei HNO-Ärzten durchgefÜhrten Diagnostik konnten bei 8% der Patienten als Ursachen Glomustumore, GefÁssanomalien und SchilddrÜsenerkrankungen erstmals im Rahmen der Tinnitussprechstunde diagnostiziert werden. Trotz frÜherer Therapieversuche konnte mit einer nochmaligen individuellen medikamentÖsen Therapie bei 6 von 47 Patienten mit chronischem Tinnitus eine audiometrisch belegbare Tinnitusbesserung erreicht werden.
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