Descriptive neuroradiology: beyond the hummingbird

Page, Inna; Gaillard, Frank

doi:10.1136/practneurol-2020-002526

Cited by 4 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In these experiments, there are no increased KC levels at the beginning of the experiments, but rather a rise over the course of the experiment, similar to that described in IPL perfusion [ 16 , 21 ]. IL-1β and IL-5 are mainly secreted from macrophages and T cells [ 22 , 23 , 24 ]. These cells would be present directly after the beginning of the experiments as adherent or tissue-resident cells [ 25 ] with possible consecutive cell death over time explaining the initial increases and following decline of IL-1β and IL-5 levels.…”

Section: Discussionmentioning

confidence: 99%

Never Change a Flowing System? The Effects of Retrograde Flow on Isolated Perfused Lungs and Vessels

Krabbe

Klassen

Bleidorn

et al. 2021

Cells

View full text Add to dashboard Cite

Retrograde perfusion may occur during disease, surgery or extracorporeal circulation. While it is clear that endothelial cells sense and respond to changes in blood flow, the consequences of retrograde perfusion are only poorly defined. Similar to shear stress or disturbed flow, retrograde perfusion might result in vasomotor responses, edema formation or inflammation in and around vessels. In this study we investigated in rats the effects of retrograde perfusion in isolated systemic vessels (IPV) and in pulmonary vessels of isolated perfused lungs (IPL). Anterograde and retrograde perfusion was performed for 480 min in IPV and for 180 min in the IPL. Perfusion pressure, cytokine levels in perfusate and bronchoalveolar lavage fluid (BALF), edema formation and mRNA expression were studied. In IPV, an increased perfusion pressure and initially also increased cytokine levels were observed during retrograde perfusion. In the IPL, increased edema formation occurred, while cytokine levels were not increased, though dilution of cytokines in BALF due to pulmonary edema cannot be excluded. In conclusion, effects of flow reversal were visible immediately after initiation of retrograde perfusion. Pulmonary edema formation was the only effect of the 3 h retrograde perfusion. Therefore, further research should focus on identification of possible long-term complications of flow reversal.

show abstract

Section: Discussionmentioning

confidence: 99%

Never Change a Flowing System? The Effects of Retrograde Flow on Isolated Perfused Lungs and Vessels

Krabbe

Klassen

Bleidorn

et al. 2021

Cells

View full text Add to dashboard Cite

show abstract

“…Three strategies were tested for visual MRI analysis. In the first strategy (“MRI visual only”) the readers were asked to first check the images for the presence (yes/no) of the hummingbird sign, 7 the Mickey‐Mouse sign, 8 and the morning‐glory sign, 6 and then to provide a dichotomic summary assessment as either “PSP patient” or “HC''. There was no specific instruction given whether or not the presence of one or more descriptive features should lead to the classification as “PSP patient''.…”

Section: Methodsmentioning

confidence: 99%

“…Several descriptive MRI features indicating midbrain atrophy have been proposed and are frequently reported in clinical routine including the hummingbird sign, the Mickey‐Mouse sign, and the morning‐glory sign 6‐8 . Various planimetric measures and combinations of planimetric measures have been validated in PSP, not exclusively focusing on the brain stem, but including adjacent structures such as the cerebellar peduncles 9‐14 .…”

Section: Introductionmentioning

confidence: 99%

“…4 Several descriptive MRI features indicating midbrain atrophy have been proposed and are frequently reported in clinical routine including the hummingbird sign, the Mickey-Mouse sign, and the morning-glory sign. [6][7][8] Various planimetric measures and combinations of planimetric measures have been validated in PSP, not exclusively focusing on the brain stem, but including adjacent structures such as the cerebellar peduncles. [9][10][11][12][13][14] More recently, fully automated MRI analysis combining atlas-based volumetry with support vector machine (SVM) classification has been proposed for the (differential) diagnosis of neurodegenerative parkinsonian syndromes including PSP.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Brain MRI in Progressive Supranuclear Palsy with Richardson's Syndrome and Variant Phenotypes

Wattjes,

Huppertz,

Mahmoudi

et al. 2023

Movement Disorders

View full text Add to dashboard Cite

BackgroundBrain magnetic resonance imaging (MRI) is used to support the diagnosis of progressive supranuclear palsy (PSP). However, the value of visual descriptive, manual planimetric, automatic volumetric MRI markers and fully automatic categorization is unclear, particularly regarding PSP predominance types other than Richardson's syndrome (RS).ObjectivesTo compare different visual reading strategies and automatic classification of T1‐weighted MRI for detection of PSP in a typical clinical cohort including PSP‐RS and (non‐RS) variant PSP (vPSP) patients.MethodsForty‐one patients (21 RS, 20 vPSP) and 46 healthy controls were included. Three readers using three strategies performed MRI analysis: exclusively visual reading using descriptive signs (hummingbird, morning‐glory, Mickey‐Mouse), visual reading supported by manual planimetry measures, and visual reading supported by automatic volumetry. Fully automatic classification was performed using a pre‐trained support vector machine (SVM) on the results of atlas‐based volumetry.ResultsAll tested methods achieved higher specificity than sensitivity. Limited sensitivity was driven to large extent by false negative vPSP cases. Support by automatic volumetry resulted in the highest accuracy (75.1% ± 3.5%) among the visual strategies, but performed not better than the midbrain area (75.9%), the best single planimetric measure. Automatic classification by SVM clearly outperformed all other methods (accuracy, 87.4%), representing the only method to provide clinically useful sensitivity also in vPSP (70.0%).ConclusionsFully automatic classification of volumetric MRI measures using machine learning methods outperforms visual MRI analysis without and with planimetry or volumetry support, particularly regarding diagnosis of vPSP, suggesting the use in settings with a broad phenotypic PSP spectrum. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

show abstract

“…It may show generalised and brainstem atrophy. An appearance known as the hummingbird sign may be seen on MRI, which is due to midbrain atrophy with preservation of the pons (Page and Gaillard, 2020).…”

Section: Diagnosismentioning

confidence: 99%

Diagnostic, management and nursing challenges of less common dementias: Parkinsonian dementias and Huntington's disease

Davis

Dening

2021

British Journal of Neuroscience Nursing

View full text Add to dashboard Cite

Background: Although most cases of dementia are caused by Alzheimer's disease or vascular dementia, around 10-15% of cases are due to other disorders, including dementias with Parkinsonian features, Huntington's disease, frontotemporal dementia, human immunodeficiency virus (HIV), and alcohol. Aims: These less common dementias are important as they may have differing clinical features and require different approaches to diagnosis and management. This paper seeks to provide relevant information for nurses about symptoms, diagnosis and management of some of the less common dementias. Methods: This is one of two connected papers, and provides a clinical overview of Parkinsonian dementias and Huntington's disease. It provides a narrative, rather than systematic, review of the literature. Findings: Parkinsonian dementias comprise Parkinson's disease dementia, dementia with Lewy bodies and so-called Parkinson's-plus syndromes (multi-system atrophy, progressive supranuclear palsy, and corticobasal degeneration). Huntington's disease is an inherited neuropsychiatric condition. Each has a distinctive clinical picture, with combinations of cognitive, neuropsychiatric and neurological symptoms but approaches to treatment and care are essentially supportive. Conclusions: Nurses have an essential role in supporting people with dementia, as well their families and carers, throughout the course of dementia from diagnosis to end of life care. They are often best placed and have the necessary skills to create appropriate care plans and to provide care management.

show abstract

Descriptive neuroradiology: beyond the hummingbird

Cited by 4 publications

References 19 publications

Never Change a Flowing System? The Effects of Retrograde Flow on Isolated Perfused Lungs and Vessels

Never Change a Flowing System? The Effects of Retrograde Flow on Isolated Perfused Lungs and Vessels

Brain MRI in Progressive Supranuclear Palsy with Richardson's Syndrome and Variant Phenotypes

Diagnostic, management and nursing challenges of less common dementias: Parkinsonian dementias and Huntington's disease

Contact Info

Product

Resources

About