A case of chronic subdural hematoma demonstrating the epileptic focus at the area with sulcal hyperintensity on fluid-attenuated inversion recovery image

Oshida, Sotaro; Akamatsu, Yosuke; Matsumoto, Yorihiko; Ishigame, Shinya; Ogasawara, Yasushi; Aso, Kenta; Kashimura, Hiroshi

doi:10.1016/j.radcr.2019.06.021

Cited by 8 publications

(2 citation statements)

References 10 publications

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“… 24 ) We previously reported sulcal hyperintensity on FLAIR in epileptic chronic subdural hemorrhage without abnormal findings in GRE T2*-WI. 25 ) The FLAIR images demonstrated diffuse hyperintensity in the cerebral sulci and basal cistern. Conversely, GRE T2*-WI has a higher detection rate of cerebral bleeding than conventional MRI sequences and CT because GRE T2*-WI is sensitive to paramagnetic materials; it can easily identify and reveal details of the lesions that contain paramagnetic matter.…”

Section: Discussionmentioning

confidence: 96%

Subarachnoid Hemorrhage Confirmed by Magnetic Resonance Imaging in a Patient with Brain Death owing to Hypoxic Encephalopathy Following Suicide by Hanging

OSHIDA,

YOKOSAWA,

ARAYA

et al. 2024

NMC Case Report Journal

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Although true subarachnoid hemorrhage (SAH) is an atypical complication owing to suicide by hanging, pseudo-SAH can often develop because of hypoxic encephalopathy. Therefore, differentiating pseudo-SAH from true SAH using brain computed tomography (CT) is often challenging. In Japan, an individual's cause of brain death must be determined to be eligible for organ donation, regardless of whether true SAH is involved or not. Herein, we report a case of SAH confirmed by magnetic resonance imaging (MRI) in a patient with brain death owing to hypoxic encephalopathy following suicide by hanging. A 48-year-old man attempted suicide by hanging. Upon arrival at the hospital, he developed pulseless electrical activity with apnea. Although spontaneous circulation returned within a few minutes of his arrival, spontaneous breathing did not recover. The patient was in deep comatose state without response to pain stimulation, brainstem reflexes, or electrical activities on an electroencephalogram. Consequently, the patient met diagnostic criteria for clinical brain death based on the Japanese organ transplantation law. Brain CT revealed global hypoxic injury and high density in the basal cisterns and subarachnoid space. Brain MR T2*-weighted imaging revealed low intensity at the left Sylvian fissure underlying the hematoma. These findings indicated brain death owing to hypoxic encephalopathy following hanging, and incidental true SAH was confirmed by MRI. Donor surgery and organ transplantation were performed. Spontaneous SAH can often develop secondary to hanging, and brain MRI can effectively determine whether the cause of brain death involves true SAH.

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Section: Discussionmentioning

confidence: 96%

Subarachnoid Hemorrhage Confirmed by Magnetic Resonance Imaging in a Patient with Brain Death owing to Hypoxic Encephalopathy Following Suicide by Hanging

OSHIDA,

YOKOSAWA,

ARAYA

et al. 2024

NMC Case Report Journal

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“…Moreover, this work describes a protocol for the segmentation of parenchymal contusions. Subdural hematomas can also appear as hyperintense regions on T2-FLAIR images (Oshida et al, 2019 ) and were commonly segmented as parenchymal lesion core by students at first ( Figure 9 ). Learning a new software for image segmentation can also hinder performance.…”

Section: Discussionmentioning

confidence: 99%

Manual lesion segmentations for traumatic brain injury characterization

Bennett

Garner

Morris

et al. 2023

Front. Neuroimaging

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Traumatic brain injury (TBI) often results in heterogenous lesions that can be visualized through various neuroimaging techniques, such as magnetic resonance imaging (MRI). However, injury burden varies greatly between patients and structural deformations often impact usability of available analytic algorithms. Therefore, it is difficult to segment lesions automatically and accurately in TBI cohorts. Mislabeled lesions will ultimately lead to inaccurate findings regarding imaging biomarkers. Therefore, manual segmentation is currently considered the gold standard as this produces more accurate masks than existing automated algorithms. These masks can provide important lesion phenotype data including location, volume, and intensity, among others. There has been a recent push to investigate the correlation between these characteristics and the onset of post traumatic epilepsy (PTE), a disabling consequence of TBI. One motivation of the Epilepsy Bioinformatics Study for Antiepileptogenic Therapy (EpiBioS4Rx) is to identify reliable imaging biomarkers of PTE. Here, we report the protocol and importance of our manual segmentation process in patients with moderate-severe TBI enrolled in EpiBioS4Rx. Through these methods, we have generated a dataset of 127 validated lesion segmentation masks for TBI patients. These ground-truths can be used for robust PTE biomarker analyses, including optimization of multimodal MRI analysis via inclusion of lesioned tissue labels. Moreover, our protocol allows for analysis of the refinement process. Though tedious, the methods reported in this work are necessary to create reliable data for effective training of future machine-learning based lesion segmentation methods in TBI patients and subsequent PTE analyses.

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