Background and purpose: Although gait disturbance is an important feature of idiopathic normal pressure hydrocephalus (NPH), only tentative theories have been offered to explain its pathophysiology. It has been sugges...Background and purpose: Although gait disturbance is an important feature of idiopathic normal pressure hydrocephalus (NPH), only tentative theories have been offered to explain its pathophysiology. It has been suggested that the mesencephalic locomotor region is the anatomical substrate for the development of the hypokinetic NPH gait. To investigate this possibility, we evaluated the correlation between gait disturbance and midbrain diameter. Methods: We enrolled 21 patients with NPH and 20 age-matched control subjects for the study. The maximal diameter of the midbrain and pons, and the width of the lateral and third ventricles were measured using midsagittal T1-weighted MRI and axial T2-weighted MRI, respectively. Gait disturbance, cognitive dysfunction, and incontinence were semiquantified. Results: The maximal midbrain diameter was significantly smaller in the NPH group than in the controls (14.8 ±0.9 vs. 17.1 ±0.7mm, p < 0.001). There were inverse correlations between the midbrain diameter and the widths of the two ventricles (r = -0.562, p = 0.008 for the third ventricle, and r = -0.510, p = 0.018 for the lateral ventricle). The severity of gait disturbance was negatively correlated with the midbrain diameter (r = -0.598, p = 0.004), but the degree of cognitive dysfunction and incontinence showed no significant correlation with midbrain diameter or ventricular width. Conclusions: This study suggests that midbrain atrophy is significantly associated with gait disturbance in NPH.展开更多
Purpose: To describe a case of recurrent frosted branch angiitis after treatme nt of ocular toxoplasmosis. Methods: In a 6-year-old boy, we found perivascula r, creamy, patchy, retinal sheathing in both eyes without a...Purpose: To describe a case of recurrent frosted branch angiitis after treatme nt of ocular toxoplasmosis. Methods: In a 6-year-old boy, we found perivascula r, creamy, patchy, retinal sheathing in both eyes without any focal necrotizing retinochoroiditis or scarring. IgM antibodies for toxoplasma gondii were also fo und. The patient was treated with antitoxoplasmosis medication and a systemic st eroid. Results: Several years after treatment of the toxoplasmosis, frosted bran ch angiitis occurred twice without any retinal scarring or serological evidence of toxoplasmosis. After systemic steroid therapy, the angiitis improved without further complications. Conclusions: Toxoplasmic retinal vasculitis should be con sidered as a cause of frosted branch angiitis.展开更多
文摘Background and purpose: Although gait disturbance is an important feature of idiopathic normal pressure hydrocephalus (NPH), only tentative theories have been offered to explain its pathophysiology. It has been suggested that the mesencephalic locomotor region is the anatomical substrate for the development of the hypokinetic NPH gait. To investigate this possibility, we evaluated the correlation between gait disturbance and midbrain diameter. Methods: We enrolled 21 patients with NPH and 20 age-matched control subjects for the study. The maximal diameter of the midbrain and pons, and the width of the lateral and third ventricles were measured using midsagittal T1-weighted MRI and axial T2-weighted MRI, respectively. Gait disturbance, cognitive dysfunction, and incontinence were semiquantified. Results: The maximal midbrain diameter was significantly smaller in the NPH group than in the controls (14.8 ±0.9 vs. 17.1 ±0.7mm, p < 0.001). There were inverse correlations between the midbrain diameter and the widths of the two ventricles (r = -0.562, p = 0.008 for the third ventricle, and r = -0.510, p = 0.018 for the lateral ventricle). The severity of gait disturbance was negatively correlated with the midbrain diameter (r = -0.598, p = 0.004), but the degree of cognitive dysfunction and incontinence showed no significant correlation with midbrain diameter or ventricular width. Conclusions: This study suggests that midbrain atrophy is significantly associated with gait disturbance in NPH.
文摘Purpose: To describe a case of recurrent frosted branch angiitis after treatme nt of ocular toxoplasmosis. Methods: In a 6-year-old boy, we found perivascula r, creamy, patchy, retinal sheathing in both eyes without any focal necrotizing retinochoroiditis or scarring. IgM antibodies for toxoplasma gondii were also fo und. The patient was treated with antitoxoplasmosis medication and a systemic st eroid. Results: Several years after treatment of the toxoplasmosis, frosted bran ch angiitis occurred twice without any retinal scarring or serological evidence of toxoplasmosis. After systemic steroid therapy, the angiitis improved without further complications. Conclusions: Toxoplasmic retinal vasculitis should be con sidered as a cause of frosted branch angiitis.
