Brain magnetic resonance imaging (MRI):Rheumatoid meningitis. (A) Axial T1-weighted sequence post-gadolinium shows faint contrast enhancement of the leptomeninges and underlying gyri over the left convexity.


Brain magnetic resonance imaging (MRI):Rheumatoid meningitis. (B) Finite areas of diffusion restriction of the left parietal cortex near the vertex on axial diffusion weighted imaging (DWI) sequence.


Brain magnetic resonance imaging (MRI):Rheumatoid meningitis. (C) Coronal T1-weighted sequence post-gadolinium shows longitudinal right frontal leptomeningeal and faint left leptomeningeal contrast enhancement.


Brain magnetic resonance imaging (MRI):Rheumatoid meningitis. (D) Axial DWI sequence shows new areas of restricted diffusion in the right frontal parafalcine region along with increased volume of restricted diffusion in left parietal cortex near the vertex.


Brain magnetic resonance imaging (MRI):Rheumatoid meningitis. (E) Axial T1-weighted sequence post-gadolinium obtained 3 months following immunosuppressive therapy showing no abnormal contrast enhancement, and left frontal postoperative changes.


Brain magnetic resonance imaging (MRI):Rheumatoid meningitis. (F) Axial DWI sequence obtained 3 months following immunosuppressive therapy and demonstrating the resolution of previously documented findings.


Meningeal histologic sections:Rheumatoid meningitis. Representative hematoxylin and eosin (H&E) stained sections. (A) Meningothelial hyperplasia (magnification 200).


Meningeal histologic sections:Rheumatoid meningitis. Representative hematoxylin and eosin (H&E) stained sections. (B) Necrobiotic core surrounded by palisading macrophages (magnification 200).


Meningeal histologic sections:Rheumatoid meningitis. Representative hematoxylin and eosin (H&E) stained sections. (C) Cluster of inflammatory infiltrate cells consisting mainly in small lymphocytes, mixed with few plasma cells and histiocytic cells (magnification 400).


Meningeal histologic sections:Rheumatoid meningitis. Representative hematoxylin and eosin (H&E) stained sections. (D) Diffuse meningeal inflammatory infiltrate (magnification 400).


(A) Seizure with a left frontotemporal focus. Ictal electroencephalography (EEG) showed rhythmic and reluctant fast (12-13 Hz) activity primarily involving the left frontotemporal area consisting of polyspikes of about 100 mV amplitude with reversal phase in the F7 lead, then epileptic discharge involved all channels and showed a reduction in frequency (6 Hz). The patient was unconscious. Discharges consisting of high-amplitude sharp waves (90-100 muV) and slow waves (prominent on the frontotemporal areas) (high 30 Hz, low 0.1 second; rate 15 mm/second).


(B) EEG during pseudoseizures. Normal background activity with interictal abnormalities in left frontocentrotemporal channels: sporadic and nonperiodic sharp waves at 100 mV with reversal phase on F7 and sporadic anterior synchronous and asynchronous theta activity (6-7 Hz, 50-60 mV). Muscular artifacts on right frontal derivations and two abrupt movement artifacts were concomitant with fictitious spasms of the patient. No epileptic seizures were recorded. This recording showed a significant reduction of interictal activity in comparison with her previous EEGs.


(a) EKG on admission. Notice the isolated ST-T segment elevation in V2.


(b) Patient's baseline normal EKG obtained a few months prior to admission.


(c) Left ventriculogram-end diastole.


(d) Left ventriculogram-end systole. Notice the severe hypokinesia to akinesia in the anteroapical area and balloon-like dilation of the LV apex during systole.


(a) Pressure tracing during pull back from left ventricle to LVOT. Notice the progressive drop of pressure.


(b) Pressure tracing from LVOT to aorta.


(c) TEE with color Doppler during systole. Notice the severe MR jet from LV to LA.


(d) Systolic anterior motion (SAM) of the anterior mitral valve leaflet. Positions of both leaflets during systole are outlined. Arrow pointing to the anterior leaflet.


Fundus photograph and OCT image of a patient with nAMD in the right eye. A; Fundus photograph before the first intravitreal ranibizumab injection showing normal optic disc cupping.


Fundus photograph and OCT image of a patient with nAMD in the right eye. B; OCT image showing the presence of CNV and SRF.


Fundus photograph and OCT image of the same patient with nAMD. A; Fundus photograph at 4 weeks after the 25th intravitreal ranibizumab injection, and before the first intravitreal aflibercept injection showing the presence of hard exudates.


Fundus photograph and OCT image of the same patient with nAMD. B; OCT image showing the residual SRF and retinal edema.


Fundus photograph and OCT image of the same patient with nAMD. A; Fundus photograph after trabeculotomy, demonstrating the absence of hard exudates.


Fundus photograph and OCT image of the same patient with nAMD. B; OCT image after trabeculotomy showing that both the SRF and the retinal edema have completely disappeared.


Multiple tense bullae-clinical aspect of bullous pemphigoid.


Erythematous plaques covered with tense blisters with clear fluid-clinical aspect of bullous pemphigoid.


Erythematous scaly plaques-clinical aspect of psoriasis vulgaris.


Atrophic epidermis with sub-epidermal blister containing numerous eosinophils and neutrophils, col. HE x 40.


Atrophic epidermis with sub-epidermal blister containing numerous eosinophils and neutrophils, col. HE x 100.


Atrophic epidermis with sub-epidermal blister containing numerous eosinophils and neutrophils, col. HE x 200.


MRI performed 10 days after onset of the second prolonged attack. Right temporal-occipital hyperintensity on T1-weighted images.


MRI performed 10 days after onset of the second prolonged attack. With gliosis on T2-FLAIR images. Suggests the chronic stage of cortical necrosis caused by first prolonged attack. Left temporal-occipital cortex hyperintensity on T2-FLAIR images.


MRI performed 10 days after onset of the second prolonged attack. With gyriform enhancement.


MRI performed 10 days after onset of the second prolonged attack. Restricted diffusion.


MRI performed 10 days after onset of the second prolonged attack. Normal apparent diffusion coefficient (ADC). Suggests the subacute stage of cortical necrosis caused by second prolonged attack.


MRI performed 10 days after onset of the second prolonged attack. MRA demonstrated vasodilation of the branches of the left middle cerebral artery (MCA) and posterior cerebral artery (PCA) (F).


MRI performed 15 days after the onset of the second prolonged attack. DWI showed extensive cortical edema with diffusion restriction involving the left hemisphere (a).


MRI performed 15 days after the onset of the second prolonged attack. T1-weighted images showed slight hyperintensity in left temporal-occipital lobe and volume loss of right temporal-occipital lobe, suggestive of subacute and chronic stage of cortical necrosis, respectively (b).


MRI performed 15 days after the onset of the second prolonged attack. Gadolinium-enhanced T1-weighted images showed cortical enhancement in the left temporal-occipital lobe (c).


MRI performed 15 days after the onset of the second prolonged attack. MRA showed dilation of left MCA and PCA (d).


MRI performed 15 days after the onset of the second prolonged attack. PWI showed increased cerebral blood flow (CBF).


MRI performed 15 days after the onset of the second prolonged attack. Cerebral blood volume (CBV). In the left hemisphere. Region of interest (ROI) placed on the left temporal-parietal area showed a mean relative CBF value of 486.1 compared with that of 123.1 on the right temporal-parietal area. ROI placed on the left temporal-parietal area showed a mean relative CBV value of 533.1 compared with that of 129.8 on the right temporal-parietal area.


Myocardial accumulation of metaiodobenzylguanidine (123I-MIBG) is low [H/M = early: 1.72.


Delayed: 1.34 ]. The circled areas indicate heart.


(a) OCT macula.


(b and c) GCL OCT.


(d) OCT optic nerve. Stable condition from four months to one year of treatment, some recovery of ANFL from the initial drop after four months.


Photograph of the baby showing fusion of lower limbs, hypoplastic thumb, absent external genitalia and features of Potter's facies.


Sirenomeliac baby with narrow chest and Potter's facies (prominent infraorbital folds, small slit-like mouth, receding chin, downward curved nose, and low-set soft dysplastic ears).


Sirenomeliac baby with fused lower limbs containing 10 toes, Potter's facies, narrow chest, and absent external genitalia.


Photograph of baby showing imperforate anus.


Family tree of the AD patient with R62C mutation. . Notes: Family members refused the genetic tests and declined to provide detailed information on their age. However, none of them presented any type of dementia symptoms. . Abbreviation: AD, Alzheimer's disease.


Clock drawing test. . Note: The contour and time setting are incorrect in the task of clock drawing.


First brain MRI. . Note: Left occipital lobe lesion showed abnormal T1 hypointensities.


First brain MRI. T2.


First brain MRI. FLAIR. Hyperintensities. . Abbreviation: FLAIR, flow attenuated inversion recovery.


Subsequent brain MRI. . Note: Lesions with abnormally high signals on FLAIR.


Subsequent brain MRI. And DWI.


Subsequent brain MRI. With poorly defined margins along the gyri in the left occipital-temporal lobe, which was slightly enhanced after gadolinium enhancement . Abbreviations: DWI, diffusion weigh imaging; FLAIR, flow attenuated inversion recovery.


(A) Axial fluid attenuated inversion recovery (FLAIR) image demonstrated cortico-subcortical atrophy and chronic cerebrovasculopathy.


(B) Diffusion weighted imaging (DWI) did not show acute lesions.


(C) Neurophysiological studies showed absence of the left sural and the right ulnar sensory nerve action potentials, mildly increased latency of the facial nerve CMAP, and normal repetitive facial nerve stimulation.


MRI imaging of brain. There are no abnormal findings in the brain MRI imaging of the patient. T1-weighted image.


MRI imaging of brain. There are no abnormal findings in the brain MRI imaging of the patient. T2-weighted image.


MRI imaging of brain. There are no abnormal findings in the brain MRI imaging of the patient. FLAIR image.


Hematoxylin and eosin (H&E) staining of the larger lesion showing basal cell carcinoma (BCC), nodular type.


Distorted and hyperplastic pilosebaceous units with prominent sebaceous glands. H&E staining of epithelial and mesenchymal components.


Myxoid and fibrillary appearance containing elongated and wavy spindle cells (H&E staining).


Immunohistochemical staining, fibrillary mesenchymal components express S-100 marker.


NSE and SMA, and desmin markers were negative in IHC staining of mesenchymal components.


MRI brain (T1W images) showing the giant intraparenchymal cyst . Multiple small cysts with scolex in vesicular stage. Black arrows).


Multiple small cysts with scolex in vesicular stage. Black arrows).


Pedigree of the family. The arrow indicates the proband. Circles indicate females, squares indicate males. The diagonal line indicates a deceased family member. Black squares/circles indicate a carrier of the FHM3 (c.4495T>C) mutation with hemiplegic migraine. White squares/circles indicate subjects that are neither patients nor mutation carriers.


EKG at time of presentation.


EKG after treatment with Ceftriaxone.


Electrocardiography: sinus rhythm, ST-segment elevation on leads V2-V5.


Echocardiography: Four chamber view showing evidence of classic takotsubo cardiomyopathy, the apical type. Represents systole.


Echocardiography: Four chamber view showing evidence of classic takotsubo cardiomyopathy, the apical type. Represents diastole.


Family tree.


Histopathology of affected lymph node of case 1 (A,B): Patchy circumscribed areas with eosinophilic fibrinoid necrosis in the paracortex and cortex and absence of granulocytes in the areas of necrosis are shown. A variety of cells surround the necrotic area, and a large number of apoptotic cell fragments exist outside the cells.


A 47-year-old man with a one-month history of dysarthria showed isolated left hypoglossal nerve palsy.


Which was improved significantly three months after microvascular decompression.


MRI (CISS, constructive interference in steady state) images of the present case. Left hypoglossal nerves (black thin arrows) originated from the ventral side of the medulla oblongata, which is composed of two bundles, and ran into the hypoglossal canal (black thick arrows) beyond the left VA (white thin arrow). It is easy to detect when compared with the contralateral side (arrow head).


Multiple aneurysms including a partially thrombosed large left MCA saccular aneurysm and a fusiform aneurysm at the left PICA were revealed. The left VA was also dilated and winding.


The left vertebral artery compressed the hypoglossal nerve from the deep side of the surgical field to the superficial side. Hypoglossal nerves were stretched by the left VA and became extremely thin (a). The left VA was moved anteriorly and attached to dura using a polytetrafluoroethylene (Teflon ) sheet and fibrin glue.


The left vertebral artery compressed the hypoglossal nerve from the deep side of the surgical field to the superficial side. Hypoglossal nerves were released (b).


Diffusion-weighted magnetic resonance imaging on admission showed increased signal intensity in the left paramedian thalamus. Arrow).


Hypothalamus. Arrow).


Upper mesencephalon. Arrow).


Cerebellum hemisphere including the superior cerebellar peduncle. Arrow).


MR scan of head axial T2W1 image showing large thalamic glioma with involvement of left temporal lobe, uniformely hyperintense.


MR scan of head on gadolinium administration showing no enhancement.


MR scan of head coronal section of enhanced MR showing limitation of tumor mainly in bilateral thalamus.


MR scan of head sagittal image showing extent of tumor till midbrain.


MR scan of head FLAIR image showing significant periventricular lucency with hydrocephalus.


Axial section of noncontrast CT scan of head on postoperative day 1, showing external ventricular drain in situ with tumor cavity.


Axial section of noncontrast CT scan of head on post operative day 5 after the removal of external ventricular drain, showing enlarged size of ventricle.


Transverse T2W images of the brain at the level of interthalamic adhesion of Also note the ventriculomegaly and thin white matter tracts (corona radiata), thin cortex and increased CSF signal ventral to the thalamus in.


Our current case with a hypoplastic/absent interthalamic adhesion (white arrow) in comparison with the interthalamic adhesion in. Of a calf without brain lesions (at 7 months of age). Compared to.


A photograph showing:. Right periorbital swelling with mild erythema, ecchymosis, subconjunctival hemorrhage, dilated, and ,tortuous episcleral veins.


Showed a restricted ocular motility.


Computed Tomography Scan of the orbits:. Axial section.


Coronal reconstruction of the venous phase of computed tomography angiography: The arrow is pointing to dilated right superior ophthalmic vein thrombosis and enlarged extraocular muscles.


Brain MRI (T1 Gadolinium-enhanced):. Axial section.


Coronal section,. T1 coronal section: the arrow is pointing to the partial extension of thrombus into the right cavernous sinus.


Sagittal section: the arrow is pointing to right SOVT.


Coronal section.


Sagittal T2-weighted MRI sequence of the FHM1 case. The MRI sequence reveals a cerebellar atrophy most pronounced in the vermis.


SPECT imaging of DAT. The figure shows images of [123I]FP-CIT binding to DAT in a healthy control (left) and in the FHM1 case. DAT availability in the striatum, ie, the ratio of specifically bound radioligand to that of non-displaceable radioligand, was severely reduced bilaterally. The reduction in DAT availability was most prominent in the putamen on the left side (approx. 39% in of the value expected in a group of age-matched controls).


H&E stain revealed atrophic fibers of round or angular shapes that arranged in small and large groups with hypertrophied fibers. Fascicular atrophy was seen. Nuclear clumps were noted.


ATPase reaction PH 4.35 revealed fiber type grouping with type-I fibers predominance. Atrophic fibers are mostly type-II.


Recorded EEG in the patient, It was recorded by bipolar setting, with sensitivity of 150 microvolt, high frequency filter of 70 Hz and low frequency filter of 1 Hz. There are generalized epileptiform 2.5-3 Hz irregular sharp and slow wave complexes.


Magnetic resonance imaging on admission. The two mass lesions in the left body of the lateral ventricle and the right cerebellum hemisphere were isointense on T1-weighted images.


Magnetic resonance imaging on admission.hypointense on T2-weighted images.


Magnetic resonance imaging on admission. The lesions were enhanced after gadolinium-diethylenetriamine pentaacetate injection (c and f).


Two weeks following hospital admission, the right cerebellum lesion almost disappeared (a).


Two weeks later, new enhanced lesions emerged in the choroid plexus of the fourth ventricle (b).


Enlarged image of the left body of the lateral ventricle lesion (c).


Intraoperative neuroendoscopic image showed irregular surface in the lateral ventricle. Many small particles were floating in the cerebrospinal fluid, which was suggestive of leptomeningeal dissemination.


(a-c) After steroid pulse treatment, the lesions almost disappeared.


(a-c) After 12 months, all the lesions had resolved and had not recurred.


Tonic clonic seizures beginning in the occipital region 7 min after IPS. X5, outer eyelid; X6, upper eyelid. SEN: 15 muV; HF: 70; TC: 0.03.


There was no epileptic discharge in VEEG 10 min after the administration of midazolam, and the background rhythm was about 8 Hz. X5, outer eyelid; X6, upper eyelid. SEN: 10 muV; HF: 70; TC: 0.1.


Computerized tomography of the lumbosacral spine. . Note: L4-L5 axial image reveals central disc extrusion with inferior migration at L4-L5 and severe central canal stenosis.


Magnetic resonance T2-weighted imaging of the lumbosacral spine. . Notes: Sagittal T2-weighted image.


Magnetic resonance T2-weighted imaging of the lumbosacral spine. Axial T2-weighted image. Reveal L4-L5 severe central canal stenosis.


Optical coherence tomography (OCT) scan showing retinal pigment epithelium (RPE) repair process in the right eye during anti-VEGF treatment. 1 month after treatment: a subfoveal OCT scan shows splitting of the RPE (yellow arrow) with persistent well defined subretinal hyperreflective material (yellow star) and subretinal fluid; b OCT scan superior to the fovea shows continuity of the hyperreflective line attributable to the RPE (white arrow) and envelopment of the hyperreflective material (white star). 9 months after initiation of treatment; c Subfoveal OCT scan shows further consolidation of the hyperreflective material with persistent splitting of the RPE (yellow arrow); d OCT scan superior to the fovea shows reducing subretinal fluid and integrity of the RPE (white arrow).


(a) Pre-operative magnetic resonance imaging (MRI) with gadolinium. T1-weighted coronal section showing a large enhancing sellar lesion with suprasellar extension, impinging the chiasm and abutting both cavernous sinuses.


(b) T1-weighted sagittal section with gadolinium showing a mixed solid-cystic component of the tumor.


The chiasm is dislocated upwards (c) T2-weighted coronal scan showing a mixed solid-cystic components of the lesion.


(a and b) CT scan performed after sudden clinical deterioration showed no clear intra- or extr-axial bleeding or fluid collection. No ischemia could be detected.


(c) The lesion of the sella had eroded the skull base.


(a and b) Intra-operative pictures, right fronto-temporal craniotomy: The brain was swelling, with evident pus in the sulci and on the brain surface.


Intra-operative picture: Inside the sellar lesion, more pus was found and drained.


(a) Haematoxilin-eosin stained section of the adenoma at 4x magnification showing neoplastic cells admixed with a robust inflammatory infiltrate with neutrophils.


(b) The same section at 10x magnification.


(c) Synaptophysin positive immunostained section(4x).


(a) Occluded right ICA with absent flow seen on color-duplex. Right ECA has adequate flow although severe atherosclerosis is evident based on turbulent color flow images.


(b) Color-duplex images of left carotid system with >70 % critical stenosis in proximal left ICA and a patent left ECA.


Fixed gaze of the patient.


Maxillary and mandibular final impressions.


Maxillary and mandibular dentures showing monoplane teeth.


Laminated 2D bar code.


Bar code positioned on palatal surface of maxillary denture.


Recess on the cameo surface on the disto-lingual flange of the mandibular denture.


Recess filled with clear auto polymerizing acrylic resin.


Bar code reader enabled mobile camera held against the denture.


Mobile screen displaying the patient's data.


Extra oral photograph showing right side facial atrophy.


Intra oral photograph showing edentulous 1st quadrant.


Orthopantomogram showing antegonial notch on right side.


Coronal section of CT showing absence of masseter muscle on right side.


MRI showing absence of parotid and submandibular salivary glands.


Clinical history of the patient from her first hospital admission to date. Each bar represents a hospitalization, detailing its duration (days) and highest concentration of creatine kinase (CK) reached. Kidney Symbol: renal failure.


Fat oxidation capacity in exercise in a healthy person vs. a patient with VLCADD. Muscle discomfort during exercise appears at intensities close to FATMAX (marked in red), modified from (10). High-intensity interval training was always at high intensity (in which the demand for fat oxidation is practically null). Completed only 40 s of the last step.


Brain MRI finding. Patient 1, (A,B) Axial T2-weighted and fluid attenuated inversion recovery (FLAIR) MR image reveals hyperintense lesion in pons.


Brain MRI finding. (C) No abnormal signal in the parietal and occipital lobes was found.


Brain MRI finding. (D,E) Follow-up MRI at 1 month shows complete resolution of the hyperintensity in the brainstem.


Changes in lead impedances and UPDRS motor part scores before and after neurostimulator replacement. . Abbreviations: DBS, deep brain stimulation; UPDRS, unified Parkinson's disease rating scale.


Fluid attenuated inversion recovery images on brain MRI. A, B. Fluid attenuated inversion recovery images on MRI demonstrated linear high signal intensity of putamen bilaterally and mild cerebellar and pontine atrophy.


Single photon emission computed tomography imaging revealed obvious hypoperfusion of the right frontal and temporal cortices, basal ganglia and brainstem, while perfusion of right cerebellar cortex was mildly impaired.


Timeline of events and tests for the case study.


A) Barre sign.


B) Curtain sign.


C) Trissulcated tongue.


Clinical course of the case.


One of 21 focal stereotyped motor seizures captured during overnight video-EEG monitoring. The patient wakes up abruptly and presents with irregular hypermotor activity in all four limbs, which lasts for about 10 seconds.


Overnight video-EEG monitoring: one of the seizures arising from non-REM sleep (stage 2). K-complex is followed by fast rhythmic activity in the frontal regions lasting for 0,3-0,5 seconds, before EEG is obscured with myographic artifacts.


Pathological findings of mediastinal lymph nodes (a, b hematoxylin and eosin staining: c immunohistochemical staining). A; Irregular necrotic areas consisted of debris and intense karyorrhexis.


B; Prominent histiocytic cells admixed with plasma cells, large lymphocytes and immunoblasts around necrotic areas without neutrophils.


C; Positive stain for CD68 on histiocytic cells.


Principle of audiovisual stimulation program (NeurofyResearch). Sequence of the visual task. (1) Eight yellow still spheres are present in a virtual cube. (2) One of these spheres turns red for 5 s (cued target) and returns to yellow. (3) All spheres randomly move following linear paths across the visual field encompassing the blind field and bouncing on one another and on the walls of the virtual 3D cube when collisions occurred. (4) After 30 s, the spheres stopped moving. (5) The patient had to select the cued target using a hand-guided virtual laser pointer. (6) A correct selection is considered a positive hit.


VHIT comparison of superimposed head [right: red; left: blue] and eye [green] velocity expressed in degrees/second (y axis) vs. Time in ms (x axis) during HIMP trials of both lateral SCCs with the "Spontaneous Nystagmus" check box selected. Included are mean VOR gain values obtained at 2 months of follow-up (A). Similar vHIT comparison of superimposed head and eye velocity in degrees/second (y axis) vs. Time in ms (x axis) during SHIMP trials; "Spontaneous Nystagmus" check box selected.


VHIT comparison of superimposed head [right: red; left: blue] and eye [green] velocity expressed in degrees/second (y axis) vs. Time in ms (x axis) during HIMP trials of both lateral SCCs with the "Spontaneous Nystagmus" check box selected. Included are mean VOR gain values obtained at 2 months of follow-up (B).


Clinical findings in case 1. (A) Preoperative fiberoscopic view. Vocal cord abduction was insufficient bilaterally, and saliva was aspirated into the subglottic area (arrow).


Clinical findings in case 1. (B) Preoperative high-resolution manofluorography (HRMF) finding. The black arrow shows the level of the upper esophageal sphincter (UES). The white arrow shows the level of the proximal esophagus (PE). HRMF revealed UES opening impairment during swallowing (white arrowhead) and abnormal deglutitive proximal esophageal contraction (ADPEC, the area surrounded by a white broken line).


Clinical findings in case 1. (C,D) Schemas of the surgery. Lateral view.


Clinical findings in case 1. (C,D) Schemas of the surgery. And axial view The removed area is encircled by a red line, and the location of the permanent tracheostoma is encircled by a blue line.


Clinical findings in case 1. (E) Postoperative HRMF finding. The resting UES pressure became low, and ADPEC disappeared postoperatively (the area surrounded by a red line).


Clinical findings in case 1. (F) Laryngeal fiberoscopic view after the surgery. The supralaryngeal mucosal surface appears smooth (arrow).


Clinical findings in case 1. (G) The videofluoroscopic swallowing study showed laryngeal closure without leakage and sufficient UES opening (arrow).


Clinical findings in case 1. (H) Permanent tracheostoma after surgery.


Clinical findings in case 2. (A) Preoperative videofluoroscopic swallowing study (VFSS). The arrow shows contrast agent aspiration into the trachea during swallowing.


Clinical findings in case 2. (B) Operative schema. The removed area is encircled by a red line, and the place of the permanent tracheostoma is encircled by a blue line. The glottic closure site is shown as a brown line.


Clinical findings in case 2. (C) Postoperative VFSS.


Clinical findings in case 2. (D) View of the permanent tracheostoma without a cannula.


Clinical findings in case 3. (A) Preoperative videofluoroscopic swallowing study (VFSS).


Clinical findings in case 3. (B) Operative schema. The removed area is encircled by a red line, and the permanent tracheostoma is located in the area surrounded by a blue line.


Clinical findings in case 3. (C) Postoperative VFSS. The arrow shows sufficient upper esophageal sphincter opening.


Clinical findings in case 3. (D) Postoperative laryngeal fiberoscopic view.


The activity of the right facial nerve in the repetitive nerve stimulation test was decreased. (A) The amplitude of the fifth wave was 30% lower than that of the first wave when the right facial nerve was stimulated at 3 Hz repetition frequency.


The activity of the right facial nerve in the repetitive nerve stimulation test was decreased. (B) The amplitude of the fifth wave was 34% lower than that of the first wave when the right facial nerve was stimulated at 5 Hz repetition frequency.


Infrared fundus photo and OCT of the left eye with hyperreflective plaques at the level of the OPL/ONL junction, with associated disruption of the inner segment/outer segment junction (ellipsoid zone).


Brain MRI at baseline (02.05.13.


After 1 month of treatment with bevacizumab plus vinorelbine at the end of posterior fossa irradiation (05.06.13.


After 11.5 months of treatment with bevacizumab plus vinorelbine (15.04.14.


Follow up imaging after 2 months shows (a) resolution of hyperintensity in cervical cord on sagittal T2 weighted MRI.


However, the lung mass was clearly evident and increased in size on,. Coronal T2 short tau inversion recovery (STIR).


T1 fat suppression.


(d) STIR coronal view shows resolution of signal changes in the nerve roots. Figures e and f shows contrast enhancing rounded opacity in the apex of left lung on computed tomography of chest.


The tumor cells are pleomorphic, round to oval in shape having high nucleo cytoplasmic ratio, hyperchromatic nuclei inconspicuous nucleoli surrounded by moderate to abundant cytoplasm suggestive of squamous cell carcinoma.


This figure shows transition of blood sugar (BS) and sodium. Corrected sodium is calculated using the formula; sodium+{(BS-100)/100*1.65}. Left bar is for BS level and right bar is for sodium concentration.


Brain magnetic resonance imaging consistent with CPM. High signal intensity lesions in the posterior central pons on T2WI (arrow head).


Low signal intensity lesion on T1WI.


High signal intensity lesion and a lesion without a decrease in the apparent diffusion coefficient on DWI.


EKG was remarkable for atrial flutter with 2 to 1 block and heart rate of 150 beats per minute.


Axial T2-weighted MR of brain demonstrates hyperin-tense signal of central pons with peripheral sparing.


Head computed tomography (CT). (A) Age 77 years.


Head computed tomography (CT). (B) Age 80 years. At 3-year follow-up (B) head CT shows selective hippocampal atrophy, but no frontal or temporal lobe lateral atrophy.


T2 and FLAIR images show hyperintense lesions in bilateral frontal lobes and thalamic and mesiotemporal regions (better seen on coronal FLAIR images). T1-weighted images show no contrast enhancement after gadolinium injection.


(A) Interictal EEG characterized by diffuse slowing and frontal spike-waves.


(B) Ictal EEG characterized by subtle SE of frontal origin.


Magnetic resonance T1 image. A round-shaped, well-limited lesion, with contrast enhancement, located in the right striatum besides the the lateral ventricle with compressive effect on the brain parenchyma and adjacent structures deviation midline approximately 8.0 mm. Surrounding edema is observed.


Magnetic resonance imaging performed 2 years after the surgery. No residual or recurrent masses are identified; there are no signs of intracranial hypertension, no extra-axial collections, or deviations from the midline.


A: EEG showing a focal flattening in bilateral central electrodes.


B: Delayed ictal focal theta (4 c/s) rhythmic activity in bilateral central electrodes.


C: EEG showing interictal spikes in the left and midline frontocentral electrodes.


A 7-year-old boy with microphthalmia, microcornea, prominent root of the nose.


Low set posteriorly placed ears.


With micropenis, cryptorchidism.


With syndactyly of the 2nd-3rd toe.


Magnetic resonance imaging of brain shows hypoplasia of corpus callosum.


Right ventriculomegaly and frontal pachygyria.


Preoperative (a-c) images of the presented case. House and Brackmann grade 6 left facial palsy was observed 13 months after the beginning of the spontaneous left facial palsy.


Classical and partial direct hypoglossal-facial anastomosis technique. The classical technique was employed in the historical cases presented in Figure 1 and has been the procedure of choice for facial reanimation for more than 100 years, since its original description by Korte in 1903. By contrast, the partial direct hypoglossal-facial anastomosis was described in 1997, and its main advantage is avoiding severe tongue atrophy. Upper left and right squares: classical technique with complete sectioning of the hypoglossal nerve. Bottom left and right squares: partial hypoglossal nerve sectioning, and anastomosis with a "longer" facial nerve obtained after drilling the mastoid bone. The main advantage of the partial section of the hypoglossal technique is avoiding the tongue atrophy.


Axial.


Coronal pelvic MRI scans demonstrating the hypertrophic tensor fascia lata (yellow) on the left as compared to the right side.


A; Sagittal section of MRI of the brain showing destruction of the clivus by the clivus tumor.


B; Coronal section of the MRI of the brain showing destruction of the clivus by the clivus tumor.


C; Poorly differentiated squamous cell carcinoma of the neoplastic cells are arranged in groups surrounded by nonneoplastic lymphoid cell component. H&E. Magnification x200.


Whereas heart rate parameters in tilt table examination and daytime sleepiness (ESS = Epworth sleepiness Scale) did not worsen over time, orthostatic symptoms (sum score of points of the Winker Scale) improved by therapy. Orthostatic intolerance improved from 3 points before therapy (orthostatic symptoms occur in most occasions and orthostatic stress regularly produces symptoms, impairment of daily activities, standing time about 1 min) to 2 points (orthostatic symptoms occur frequently, at least once a week and orthostatic stress usually produces symptoms, standing time about 5 minutes). HF=Heart rate.


Quantitative sensory testing before and after treatment: the z-profile in QST at the left side shows a central sensitization before treatment (gain of function in PPT and MPS, 2 paradoxical heat sensations), which improves under therapy. Hyperalgesia (gain of function in MPT) and hypesthesia (loss of function in MDT and CDT) developed over time. CDT = cold detection threshold; WDT = warm detection threshold; TSL = thermal sensory limen; CPT = cold pain threshold; HPT = heat pain threshold; MDT = mechanical detection threshold; MPT = mechanical pain threshold; MPS = mechanical pain sensitivity; WUR = wind-up ratio; VDT = vibration detection threshold; PPT = pressure pain threshold; DMA = dynamic mechanical allodynia; PHS = paradoxical heat sensation.


Bilateral GPi-DBS in an adolescent DYT6 dystonia patient. (A) Image-guided frameless stereotaxic surgery was performed to implant DBS leads into GPi in the 12-year-old boy under general anesthesia.


Bilateral GPi-DBS in an adolescent DYT6 dystonia patient. Axial.


Bilateral GPi-DBS in an adolescent DYT6 dystonia patient. Coronal.


Bilateral GPi-DBS in an adolescent DYT6 dystonia patient. Sagittal images of O-arm (left panel, arrowheads), and fusion images with pre-operative MRI (right panel, arrows) indicating the location of DBS electrodes in bilateral GPi.


MRI brain (with gadolinium contrast) of patient on presentation showed multifocal hyper intensities in cortical and subcortical location of parietal, temporal, frontal lobes, basal ganglia, thalami, pons and left side midbrain causing localized swelling, mild compression upon frontal horns of lateral ventricles. Ring like enhancements in some lesions of basal ganglia, thalami and pons.


Comparison of MRI before and after 1 week treatment.


MRI brain flair- fluid attenuated inversion recovery (FLAIR) axial image showing communicating hydrocephalous with periventricular hyperintensities (red arrow).


CT brain plain showing resolution of hydrocephalous following external ventricular drainage.


(a-c) Computed tomography of the patient - The views showing the olfactory regions.


Interictal electroencephalogram during sleep showing quasi-continuous, centro-temporal, and high voltage spike-and-wave complexes, frequently followed by theta-delta activity.


Brain MRI FLAIR protocol, showing signal hyperintensity, and atrophy at the mesial temporal level and bilateral hippocampi.


Brain MRI shows signal hyperintensity at the level of the basal nuclei (caudate nucleus head and putamen) on the right side in the FLAIR protocol (A).


Discrete hyperintensity is also observed in the same region in the T1 protocol (B).


Brain magnetic resonance imaging on the second day after onset. Brain MRI showed diffusion restriction in diffusion-weighted imaging (DWI) and hyperintensity of fluid-attenuated inversion recovery (FLAIR) in the bilateral parieto-occipital lobe on the second day after onset.


Case 1 - Fixation-off sensitivity.


Case 1 - FLAIR ax, T2 ax.


Case 2 - awake 5 y. o. (ipsilateral mastoid reference montage).


Case 2 - FLAIR ax, T2 ax.


EMG of the upper and lower limbs of our patient. A EMG of the left biceps brachii muscle: manual muscle testing 2/5, fibrillation potentials and positive sharp waves at rest, polyphasic small-amplitude short-duration motor unit potentials with movement (myopathic potentials). B; EMG of the left flexor digitorum sublimis muscle: manual muscle testing 4/5, absence of potentials or positive sharp waves at rest, polyphasic high-amplitude and high-frequency potentials with movement (neuropathic potentials).


EMG of the upper and lower limbs of our patient. A EMG of the left biceps brachii muscle: manual muscle testing 2/5, fibrillation potentials and positive sharp waves at rest, polyphasic small-amplitude short-duration motor unit potentials with movement (myopathic potentials). C; EMG of the left flexor digitorum profundus muscle: manual muscle testing 2/5, fibrillation potentials and positive sharp waves at rest, polyphasic small-amplitude short-duration motor unit potentials with movement (myopathic potentials).


EMG of the upper and lower limbs of our patient. A EMG of the left biceps brachii muscle: manual muscle testing 2/5, fibrillation potentials and positive sharp waves at rest, polyphasic small-amplitude short-duration motor unit potentials with movement (myopathic potentials). D; EMG of the left vastus lateralis muscle: manual muscle testing 3/5, fibrillation potentials and positive sharp waves at rest, polyphasic high-amplitude and high-frequency potentials with movement (neuropathic potentials).


EMG of the upper and lower limbs of our patient. A EMG of the left biceps brachii muscle: manual muscle testing 2/5, fibrillation potentials and positive sharp waves at rest, polyphasic small-amplitude short-duration motor unit potentials with movement (myopathic potentials). E; EMG of the left tibialis anterior muscle: manual muscle testing 1/5, severe fibrillation potentials and positive sharp waves at rest, rare polyphasic small-amplitude short-duration motor unit potentials with movement (myopathic potentials).


EMG of the upper and lower limbs of our patient. A EMG of the left biceps brachii muscle: manual muscle testing 2/5, fibrillation potentials and positive sharp waves at rest, polyphasic small-amplitude short-duration motor unit potentials with movement (myopathic potentials). F; EMG of the left extensor digitorum brevis muscle: manual muscle testing 4/5, absence of potentials or positive sharp waves at rest, polyphasic high-amplitude and high-frequency potentials with movement (neuropathic potentials).


T2-FLAIR-weighted brain MRI of our proband. A; Axial image throughout the hippocampal structures: bilateral temporal atrophy.


T2-FLAIR-weighted brain MRI of our proband. B; Axial image throughout the frontal lobes: bilateral frontal atrophy.


T2-FLAIR-weighted brain MRI of our proband. C; Sagittal image: frontal atrophy.


T2-FLAIR-weighted brain MRI of our proband. D; Coronal image: bilateral temporal atrophy.


FDG PET scan in our proband: severe bilateral hypometabolism, involving especially the frontal and temporal lobes.


Onset of NCSE (thick arrow) on initial EEG after admission. This epoch of the EEG shows onset of NCSE with diffuse slowing of 2- to 2.5-Hz delta and left greater than right hemispheric spikes (thin arrows).


The patient with severe hypotonia and facial dysmorphism.


Tc-99m glucohepatonate single-photon emission computed tomography done after 1 week of magnetic resonance-positron emission tomography. Single-photon emission computed tomography image.


Tc-99m glucohepatonate single-photon emission computed tomography done after 1 week of magnetic resonance-positron emission tomography. Fused single-photon emission computed tomography/ computed tomography. Acquired post-Tc-99m glucohepatonate injection showing uptake corresponding to the areas of enhancement on magnetic resonance imaging (white arrow in a and black arrow in b). Note that the areas of gyral uptake seen on positron emission tomography images are no longer appreciated.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. At presentation, coronal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. Sagittal. Views showing expanded sella with thick-walled sellar/suprasellar mass with extension into the right sphenoid sinus, dorsum sellae, and clivus.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. At one month after resection, coronal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. Sagittal. Views showing recurrence and of the enhancing mass centered in the sphenoid sinus with locoregional involvement, new bulging into the right cavernous sinus and involvement of right Dorello's canal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. At three months after resection, coronal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. Sagittal. Views showing significant increase in size of the mass. The lesion involved the sphenoid sinus and posterior ethmoid air cells, elevating the sellar floor and displacing the pituitary gland superiorly. The lesion extended to the cavernous sinus and abutted the cavernous carotid arteries, with erosion of the posterior cortex of the clivus, mild retroclival extension with dural involvement, and partial encasement of the basilar artery.


MRI brain demonstrating metastases to brain. Axial.


MRI brain demonstrating metastases to brain. Coronal. Views of the brain demonstrating the presence of brain metastasis.


MRI brain showing leptomeningeal disease. (a) T1 axial MRI with contrast depicting new enhancement along superior cerebellar folia compatible with leptomeningeal disease.


MRI brain showing leptomeningeal disease. (b) Abnormal leptomeningeal enhancement along posterior margin of splenium of corpus callosum.


ECG shows concave ST elevation over lead I, II, V2, V5 and V6.


CT Brain shows subacute infarct of right corona radiata.


Penal A and B show the diastolic and systolic phase of ventriculogram which showing ventricular apical ballooning.


Preoperative MRI indicating a partially thrombosed large aneurysm, its maximum diameter 22 mm, in the posterior fossa. It compressed the medulla oblongata posteriorly (a).


Preoperative MRI indicating a partially thrombosed large aneurysm, its maximum diameter 22 mm, in the posterior fossa. Preoperative MRA disclosing a large thrombosed aneurysm of the right VA (arrow) (b).


Preoperative MRI indicating a partially thrombosed large aneurysm, its maximum diameter 22 mm, in the posterior fossa. Follow-up MRI showing that the VA aneurysm decreased in size several months after treatment (c).


A; Fundus photograph 6 months after the last surgery. RAMA was organized (white arrowhead) and subfoveal hemorrhage was absorbed.


B; OCT finding 6 months after the last surgery. MH was successfully closed.


Timeline course of the patient's COVID-19 disease.


Axial MR brain image showing subtle signal change in the right as compared to the left amygdala.


12-Lead ECG. At admission showing incomplete right branch block, left anterior-superior divisional block, left axis deviation of the QRS, 2:1 AV block, corrected QT interval prolongation (689ms), and ,inverted T waves.


At discharge showing resolution of T wave inversions and shortening of the QT interval after pacemaker implantation.


Transthoracic echocardiographic 4-chamber view of the left ventricle in diastole.


In systole. Shows basal hypercontractility (green arrow) and midapical ballooning (yellow arrow).


Cardiac magnetic resonance 4-chamber view of the left ventricle in diastole.


In systole. Showing hypercontractility (green arrow) and typical apical ballooning (yellow arrow) in takotsubo syndrome.


Computed tomography imaging of the head 6 years before presentation showing intraventricular pneumocephalus and the VP shunt catheter (white arrow).


Computed tomography imaging of the head showing enlargement of the inferior horn of the lateral ventricles (black dotted circles).


Axial temporal bone computed tomography imaging showing a mastoid fluid collection (white dotted circle). , right side.


Axial temporal bone computed tomography imaging showing a mastoid fluid collection (white dotted circle). , left side.


Coronal temporal bone computed tomography imaging showing a mastoid fluid collection and a defect of the petrous bone (white arrow). , right side.


Coronal temporal bone computed tomography imaging showing a mastoid fluid collection and a defect of the petrous bone (white arrow). , left side.


Sagittal temporal bone computed tomography imaging showing a mastoid fluid collection and a defect of the petrous bone (white arrow). , right side.


Sagittal temporal bone computed tomography imaging showing a mastoid fluid collection and a defect of the petrous bone (white arrow). , left side.


Intraoperative microscopic image showing a temporal lobe parenchymal herniation into the mastoid air cells through lacerated dura and a defect site of petrous bone (white arrow).


Intraoperative microscopic image showing lacerated dura after herniated temporal lobe was interrupted (white arrow).


Intraoperative microscopic image showing the defect site covered by the pericranial graft (white dotted circle). Figure 9: Intraoperative image showing the extradural space closure using an abdominal fat graft (white arrow).


Intraoperative image showing the extradural space closure using an abdominal fat graft (white arrow).


Intraoperative image showing a temporalis muscle flap sutured to the middle cranial fossa dura.


Position of the patient's eyes in all the gazes at the time of presentation showing significantly restricted ocular movement in upgaze and mild restriction in downgaze.


MRI scan of the brain showing tiny infarct (white arrow) in the left paramedian rostral upper midbrain at the level of the red nucleus;. Axial diffusion weighted image showing restricted diffusion in the T2 hyperintensity.


Axial T2 fat saturated image showing T2 hyperintense focus.


Mid-sagittal T2-weighted magnetic resonance imaging (MRI) 15 years before admission showed an L5/S1 disc herniation (on of the Yellow Ligament. Or longitudinal (a).


Mid-sagittal T2-weighted magnetic resonance imaging (MRI) 15 years before admission showed an L5/S1 disc herniation (on of the Yellow Ligament. Mid-sagittal and axial T2-weighted MRI 10 months before admission demonstrated cauda equina compression at L4/5 caused by a hypointense anterior central disc herniation ( ) and a posterior isointense lesion ( ) (b and c).


Mid-sagittal and axial T2-weighted magnetic resonance imaging after hospital admission demonstrated cauda equina compression caused by progression of the L4/5 disc herniation ( ) (a and b).


Mid-sagittal and axial computed tomography (CT) revealed ossification of the yellow ligament at the L4/5 level ( ) (c and d).


Postoperative mid-sagittal and axial T2-weighted magnetic resonance imaging confirmed cauda equina decompression (a and b).


Mid-sagittal and axial computed tomography confirmed complete removal of the ossified yellow ligament (c and d).


Clinical photograph showing erythematous papulonodular lesions on extensor aspect of forearms and arms.


Erythematous plaques with ill-defined irregular borders on back of arms and shoulders.


Histopathology showing superficial and deep periadnexal granulomatous inflammation with neutrophils around vessels. Few foci with fragmented acid fast bacilli (x100 magnification).


Preoperative sagittal T2-weighted magnetic resonance imaging (MRI) without contrast.


Axial T2-weighted MRI scan without contrast. Demonstrate an extradural T2 hypointense lesion in the dorsal epidural space at the level of L2-L3 with severe thecal sac compression (white arrow).


Axial T2-weighted MRI scan without contrast. Demonstrate an extradural T2 hypointense lesion in the left dorsal epidural space at the level of L5-S1 with compression of the thecal sac and left S1 nerve root (white arrow).


Clinical timeline, IQ, and EEG. (A) Clinical timeline representing the evolution of serological values of creatinine kinase, thyroid-stimulating hormone (TSH), TPO autoantibodies and thyroxine levels. Treatment intervention is also illustrated as well as qualitative disease progression.


Clinical timeline, IQ, and EEG. (B) IQ progression by Wechsler intelligence scale for children. Total IQ (TIQ), verbal IQ (VIQ), and performance IQ (PIQ) at the age of 6, 8, and 13. The average score for the test is 100, and any score between 90 and 109 is considered to be in the average intelligence range.


Clinical timeline, IQ, and EEG. (C) EEG showing generalized spike and wave discharge with right frontal dominance during photic stimulation with 50 Hz.


Axial T2-weighted.


As well as coronal.


Axial. T1-weighted MRI following administration of gadolinium showing thickening and enhancement of the right oculomotor nerve in its interpeduncular and suprasellar cisternal course.


Brain imaging showing bilateral aneurysms. T1-weighted axial brain magnetic resonance (MR) scan showing large bilateral cavernous carotid aneurysms (CCAs), with a larger multilobulated aneurysmal sac on the right.


Brain imaging showing bilateral aneurysms. Brain computed tomography (CT) angiography showing large bilateral CAAs measuring approximately 21 x 17 x 16 mm on the right, and ,18 x 15 x 16 mm on the left.


Brain imaging showing bilateral aneurysms. MR and CT angiography confirming the presence of large bilateral CAAs, unchanged in size from previous scans.


Diffusion weighted images reveal restricted diffusion with hyperintense signal involving bilateral para-sagittal parietal regions, body and splenium of corpus callosum, external capsules, thalami and cerebellar peduncles (2A D). Corresponding ADC images show corresponding decreased signal in the above mentioned lesions (2E-2H).


(a) Axial computed tomography showing erosion in the right hypoglossal canal.


(b and c) Axial T1- and T2-weighted images showed cystic lesion.


(d-f) Gd-diethylenetriaminepentaacetic acid enhanced images showed mild contrast effect.


Transfontanelle sonography shows large cyst-like cisterna magna that suggested cerebellar hypoplasia and slightly dilated frontal horns of the lateral ventricles.


(A) Sagittal T1-weighted image shows hypoplastic cerebellum (cerebellar hemispheres more affected than vermis) associated with a small pons.


(B) Coronal T1-weighted image shows markedly hypoplastic cerebellar hemispheres (dragonfly-like cerebellar pattern), with dilatation of the cisterna magna inferiorly and also cortical and cerebral atrophy.


Cosman-Roberts-Wells (CRW) head frame used for rigid fixation to cranium for stereotactic neurosurgery. Frame is affixed to cranium via four screws placed through graphite posts (red arrows). Outer cage (black arrow) serves as a CT localizer for image registration.


Positioning of potential patient in CRW frame, prior to CT scanning.


Simulation of intraoperative CT scanning for image registration and DBS planning.


Simulated patient perspective of presurgical positioning, situated from within the CRW frame, prior to draping.


Surgical positioning after sterile draping. The sterile field is located behind the drape (not visualized), whereas the interactive patient space is located on the near side of the drape (visualized). This arrangement allows for the team to perform "awake" examination of the arms, legs, and face during deep brain stimulation.


Simulated patient perspective, after sterile draping, during the DBS procedure. The patient may experience this viewpoint for 4-6 h, as the surgery is being performed.


Axial T1 weighted.


T2 weighted. Images, at the level of basal ganglia, show that corresponding areas of restricted diffusion do not reveal any signal abnormality.


Axial fluid attenuated inversion recovery (FLAIR).


Diffusion weighted image.


Corresponding apparent diffusion coefficient (ADC) map. Of magnetic resonance imaging of the brain done after 4 weeks shows resolution of diffusion abnormalities and mild generalized cerebral atrophy.


(a) Ultrasound image of the brachial plexus between the anterior and middle scalene muscle.


Arrows indicate brachial plexus (BP); (b) Ultrasound image of spreading the drugs around the brachial plexus. Arrowheads indicate the needle. Arrows indicate BP. ASM anterior scalene muscle, MSM middle scalene muscle, SCM sternocleidomastoid muscle, * injected drug surrounding the BP.


Picture of severe bruise after fall due to dizziness of adverse effect of medication in Case 2.


Ultrasound image of the lumbar plexus block in the posterior part of the psoas muscle (PM). Arrows indicate lumbar plexus (LP). Arrowheads indicate the needle. ESM erector spinae mescle, PM psoas muscle, TPL4 transverse process of L4, TPL5 transverse process of L5.


Family history of patient. She did not have any family history of disease. Notes: Parents I 1, and . . 2) and 3 siblings. (II-1, II-3, II-5) of patient (II-2) were unaffected. The 3rd sibling (II-4) died in his 40s.


Herpes zoster in a right-sided T10-12 dermatomal distribution. The vesicular crusts has fallen off leaving temporary pigmentation.


Brain magnetic resonance sequencing diffusion-weighted imaging.


Showed high signal intensities over bilateral occipital regions whereas in Apparent Diffusion Coefficient Mapping. Showed decreased signals (black arrows).


Follow-up brain magnetic resonance imaging - fluid attenuated inversion recovery sequencing showed resolution of bilateral occipital lesions with symmetrical putaminal high signal abnormalities (black arrows).


Patient's copy of Rey Complex Figure showing lack of planning, perseveration, visuoconstructional and visuomotor difficulties.


Brain MRI showing: [A] (T2-weighted coronal section) mild hippocampal atrophy; [B] (sagittal T1 section) demonstrates: mild cerebellar and posterior callosum atrophy.


Location of acupoints for the electroacupuncture.


Continuous scalp EEG recording before and after electroacupuncture. Epileptic discharges before electroacupuncture.


Continuous scalp EEG recording before and after electroacupuncture. EEG suppression after electroacupuncture. EA, electroacupuncture.


Repetitive nerve stimulation at the time of initial evaluation. Repetitive stimulation of the tibial nerve performed before . (A) Repetitive nerve stimulation prior to administration of edrophonium chloride showed a decrement of 74% between the first and fifth waves.


Repetitive nerve stimulation at the time of initial evaluation. After. Intravenous administration of edrophonium chloride (0.1 mg/kg). Nerve stimulation was performed at the level of the hock, and complex muscle action potentials (CMAP) were recorded from the interosseous muscle. Stimulus rate = 2 Hz. Stimulus duration = 0.1 ms. Repetitions = 10. Normal response = no decrement >10% of the starting CMAP amplitude or area. (B) Repetitive nerve stimulation after administration of edrophonium chloride showed a persistent but less severe decrement of 37% between the first and fifth waves.


Electroencephalogram of Case 2 prior to antiepileptic therapy. A; Left temporal sharp wave; b Left temporal slowing.


Head computed tomography (CT). Head CT showing type I lissencephaly with midline calcification.


Facial photograph of the patient. The typical facial features of Miller-Dieker syndrome (MDS) are seen. These features include prominent forehead, bitemporal hollowing, short nose with upturned nares, prominent upper lip, and micrognathia.


MRI with difuse cortical atrophy, frontal predominance.


SPECT with Frontal lobes hypoperfusion.


A 61-year-old female patient was admitted with transient fecal incontinence and an asymptomatic lumbar disc herniation: (a and b) magnetic resonance imaging sagittal T2 of the lower abdomen demonstrates a hernia between L5-S1 (sacrum) (arrow).


(A) The EEG monitoring showed the release of sharp-slow and spinous-slow waves in the left posterior temporal region and the right middle posterior temporal regions.


(B) Patient's picture showing a funnel-shaped chest.


(C) Partial CNNM2 electropherograms of the patient and her parents. In the electropherograms, the variant is indicated by a red box and the changes in nucleotide and resulting effects on the protein are shown.


(D) Localization of the variant in the secondary structure of CNNM2. The N-terminal extracellular domain and the transmembrane domain are in light blue and dark blue respectively. The CBS domain is in purple, the CNBH domain is in green, and the unstructured C-terminus is yellow. *means stop codon. The location of pathological variant is indicated by a cross.


(E) variant domains of cases listed in Table 1. In 24 cases, we found 5 domains: extracellular (5/24), bateman module (3/24), UF21(9/24), CNBH(4/24), and signal peptide(1/24). The other two cases were not available (2/24).


Microscopy of CSF culture demonstrating Candida albicans.


Preoperative magnetic resonance image showing focal cortical dysplasia at the insula, frontal and parietal opercula.


Post-operative fluid-attenuated inversion recovery magnetic resonance image showing increased signal intensity in the right insula, which was the epileptogenic region.


Pre-radiosurgery coronal.


Axial.


Zoom out. View magnetic resonance images showing residual lesions in the operculo-insular area (within the red rectangles).


Pre-radiosurgery interictal electroencephalogram showing sharp waves (within the red circles) in the right temporal-frontal area, which is suggestive of right temporal-frontal epilepsy.


Dose-volume histogram of gross target volume and organs at risk.


(A) Sagittal FLAIR MRI sequence showing cerebral atrophy with a frontotemporal predilection and post-ischemic hyperinsities in the white matter.


(B) Axial FLAIR MRI sequence showing asymmetry of frontotemporal atrophy with left-side predominance. FLAIR, fluid-attenuated inversion recovery; MRI, magnetic resonance imaging.


Macroscopic and microscopic findings of histopathological examination of brain tissue. (A) Diffuse brain atrophy with the compensatory dilatation of the lateral and third ventricles; the atrophy was most pronounced in the frontotemporal regions, particularly in medial temporal lobes.


Macroscopic and microscopic findings of histopathological examination of brain tissue. (B) Lewy bodies in the neurons of the amygdala (HandE, magnification 400x).


Macroscopic and microscopic findings of histopathological examination of brain tissue. (C) Lewy bodies, dystrophic Lewy neurites and dots in the amygdala (alpha-syn 5G4, magnification 200x).


Macroscopic and microscopic findings of histopathological examination of brain tissue. (D) Neurofibrillary tangles and threads in the hippocampus (AT8, magnification 200x).


Macroscopic and microscopic findings of histopathological examination of brain tissue. (E) beta-amyloid deposits in the hippocampus (beta-amyloid, magnification 200x).


Macroscopic and microscopic findings of histopathological examination of brain tissue. (F) Plaques in the frontal cortex (AgNOR, magnification 100x).


Color fundus photograph showing optic disc pallor and foveal atrophic changes in a bull's eye configuration in both eyes.


MRI scan of the orbit showing no evidence of active neuritis or infiltration of the optic nerves.


Fundus fluorescein angiography showing window defects with mottled hyperfluorescence in the parafoveal region in both eyes.


Preoperative. Plain computed tomography (CT).


CT angiography of case 1.


Postoperative. Plain computed tomography.


Diffusion weighted-magnetic resonance imaging of case 1.


Postoperative. Digital subtraction angiography.


Plain computed tomography (sagittal image) of case 1.


Diffusion weighted-magnetic resonance imaging of case 2.


Postoperative digital subtraction angiography of case 2.


A venacavagram performed during IVC filter placement demonstrating filling defect near the confluence of the common iliac veins.


With delayed reconstitution of contrast flow into the right, but not left, common iliac vein Findings are consistent with an occlusive thrombus in the left common iliac vein with extension into the proximal IVC which is near-occlusive in nature.


(a) Sagittal T1-weighted MR sequence revealing a lesion in the L5-S1 anterior epidural space that is heterogeneously hypointense (arrow).


(b) Sagittal T2-weighted MR sequence with anterior spinal epidural lesion that is mixed iso- and hyperintense centrally with a rim of hypointensity peripherally (arrows), most prominently seen at L4-S1 but also present at T12-L3 levels. There is evidence of mass effect with compression of the thecal sac.


Sagittal.


Axial. Images of gadolinium-enhanced T1 MR sequence. Arrows depict heterogeneous contrast-enhancing lesions in the anterior epidural space that have serpiginous fill void centrally.


Pedigree of a family with Benign Familial Neonatal Convulsion involving 10 members in two successive generations.


Preoperative views of the patient.


The preoperative lumbar spinal magnetic resonance imaging (T1-weighted axial and sagittal views).


Lateral view of the patient after bilateral subthalamic nucleus-deep brain stimulation at 6th month.


A; Lens partially subluxated into the anterior chamber. The crystalline lens is incarcerated in the pupil.


B; The whole corneal endothelium is touched by the iris and crystalline lens.


A; Dry vitrectomy was performed to get enough retrolental space and prevent sudden decreasing intraocular pressure after lens extraction.


B; Intracapsular lens extraction was performed with a lens spoon.


Axial.


Sagittal. T1-weighted Gd-enhanced magnetic resonance imaging (MRI) on admission, showing a contrast-enhancing sinonasal mass with intracranial extension through the cribriform plate into the anterior cranial fossa.


Postoperative axial.


Sagittal. T1-weighted Gd-enhanced MRI demonstrating complete removal of the sinonasal and intracranial tumor.


Magnetic resonance imaging on second admission. The T2-weighted images (WI).


Magnetic resonance imaging on second admission. Gd-enhanced T1-WI. Sagittal images show multiple intradural lesions between C3 and Th4.


Magnetic resonance imaging on second admission. Gd-enhanced axial T1-WI images reveal compression of the spinal cord along its right ventral aspect at C4/5.


Magnetic resonance imaging on second admission. And C5/6.


Magnetic resonance imaging performed 1 week after the surgery. The T2-weighted images (WI).


Magnetic resonance imaging performed 1 week after the surgery. Gd-enhanced T1-WI. Sagittal images demonstrate residual tumor.


Magnetic resonance imaging performed 1 week after the surgery. Gd-enhanced T1-WI axial images at the level of C4/5.


Magnetic resonance imaging performed 1 week after the surgery. C5/6. Show the decreased compression of the spinal cord.


Dissection of the right internal carotid artery, which was the etiology for amaurosis fugax. This is noted as a string sign, representing the extent of the dissection.


Dissection of the right internal carotid artery is noted in a transverse view.


The presence of optic disc temporal atrophy, superior-nasal split bundles (arrow) and borderline inferior-nasal split bundles (arrow) in SD-OCT. . Abbreviations: I, inferior; INF, inferior; N, nasal; NAS, nasal; OD, right eye; OS, left eye; S, Superior; SD-OCT, spectral domain optical coherence tomography; SUP, superior; T, temporal; TMP, temporal.


An abnormal vascularization is seen in the inferomedial portion of the posterior limb of the right internal capsule on computed tomography angiography (arrow).


Brain axial magnetic resonance imaging T1-weighted sequence after gadolinium intravenous administration showing thickening and enhancement of bilateral vestibulocochlear nerves and solitary lesion in right cerebellar hemisphere.


Entire stomach wall infiltrated with solid nests of tumor tissue, with occasional central necrosis. Tumor is adenocarcinoma grade III. . Notes: Hematoxylin and eosin stain; x200 magnification.


Axial computed tomography abdomen and pelvis demonstrating L4 vertebral body destructive metastases (*) with extraosseous extension into the spinal canal, spinous process, and left paraspinal musculature measuring 7.8 x 7.1 cm.


L3 posterior vertebral body metastasis (arrow head) with intraosseous extension into the spinal canal measuring 2.1 x 2.0 cm.


Sagittal magnetic resonance imaging of the lumbar spine demonstrating near-complete marrow replacement of the L4 vertebral body (*) with expansile, locally destructive soft tissue with extension into the left posterior elements and spinous process (a). Associated extra cortical extension of disease with circumferential encasement of the epidural space resulting in extremely severe spinal canal stenosis with compression of the cauda equina nerve roots.


There is also replacement of the posterior aspect of the L3 vertebral body (arrow head) and associated 20 percent posterior pathological compression fracture deformity (b). Frank extra cortical disease extension at this level results in moderate spinal canal narrowing with asymmetric effacement of the left lateral recess and compression of the traversing left L4 nerve roots.


Lateral.


Anterosuperior. X-rays of the lumbar spine demonstrating placement of a L4 corpectomy with placement of a cage and quad rod, pedicle screw instrumentation at L1, L2 and L3, L5, S1, and across the sacroiliac joints with an interlock at the L4 level.


Computed tomography head demonstrating a large expansile transcalvarial lesion centered at the right occipital convexity measuring approximately 7.1 x 2.3 cm transaxially (a) with resultant sulcal effacement of the subject temporal, parietal, and occipital lobes and expansion into the adjacent scalp soft tissues.


Magnetic resonance imaging of the mass is also demonstrated (b).


Photographs of patients. The photographs show FOG.


Photographs of patients. And that it is released by imagining bicycling alone.


Axial contrast-enhanced T1-weighted fat saturated image shows thickened enhancing pachymeninges in the right middle cranial fossa and paracavernous region (a-thin arrows).


Thickened pachymeninges can also be seen on T2-weighted constructive interference at steady state (CISS) images also (b-thin arrows).


Digital subtraction angiography (DSA) of the aortic arch.


Abdominal aorta. Shows the left subclavian occlusion (thick arrow) and the non-visualization of the left renal artery with narrowing of the juxta renal abdominal aorta (arrow head), respectively.


Coronal T2-weighted image.


Axial Fluid Attenuated Inversion Recovery (FLAIR) sequence. Shows subcortical white matter hyperintensity in right temporal lobe extending in to the overlying cortex.


MRI on the brain. MRI on the brain has shown acute right basal ganglia infarct. FLAIR.


MRI on the brain. MRI on the brain has shown acute right basal ganglia infarct. DWI.


MRI on the brain. MRI on the brain has shown acute right basal ganglia infarct. ADC.


MRI on the brain. MRI on the brain has shown acute right basal ganglia infarct. PWI.


Anteroposterior X-ray of the thorax does not show evidence of any pathology, no parahiliar consolidations, and no other variations (a).


Anteroposterior abdominal radiography where no abnormal changes are seen (b).


Electroencephalogram demonstrates the presence of cyclic and inverted waves. These waves are seen in the occipital region and where a marked, diffuse slowing occurs (a).


View of hyphae in brain biopsy, showing positivity for periodic acid Schiff (PAS), in which regular hyphae are observed at acute angles, as is a round conidiophore on completion of the hyphae; PAS x400 (a).


Stained hyphae with the Silver technique, showing reinforced walls, regular and septa that were observed with a more reinforced black color, forming acute angles characteristic of Aspergillus walls; Grocottmethenamine silver x400 (b).


Magnetic resonance imaging brain diffusion-weighted imaging images (axial cuts) showing acute infarct in the right thalamus involving the anterior and paramedian regions.


The hypothalamus.


Corneal photographs of lattice corneal dystrophy type IV patients. (A) The right eye was the more severely affected eye, displaying nodulolinear amyloid deposits (arrow).


Corneal photographs of lattice corneal dystrophy type IV patients. (B) The deposits are mainly located in anterior stroma (arrowhead).


Corneal photographs of lattice corneal dystrophy type IV patients. (C) The left eye showed less linear and macular opacity than the right.


The axial flair MRI of the brain of the patient with periventricular confluent hyper signal plaques.


Sagittal T2 magnetic resonance imaging demonstrating massive L5S1 disc herniation.


Axial magnetic resonance imaging image showing herniated disc fragment occupying >50% of the spinal canal in the axial plane at the L5S1 level.


Myelographic magnetic resonance imaging sequence demonstrating complete "obstruction" at L5S1.


Follow-up magnetic resonance imaging at 3 months showing near-complete resolution of L5S1 disc herniation.


(A) Transverse plane of cranial MRI in constructive interference in steady state (CISS) sequence showing left-sided abducens nerve hypoplasia. Both abducens nerves are indicated by a white arrow.


(B) Coronal plane of cranial MRI in native T1 sequence illustrating relative atrophy of the lateral rectus muscle (white arrow) in comparison to the contralateral right side.


A,b) The slit lamp photos at presentation show the chemosis, conjunctival congestion and shallow anterior chamber with clear cornea.


C) The ultrasonogram shows a thick ocular coat with subtenon fluid.


D) The ultrasound biomicroscopy reveals supraciliary effusion (^) and anterior rotation of the ciliary body.


E,f) Fundus photo and fluorescein angiogram show the choroidal folds.


A) The color fundus photo shows resolved choroidal folds 1 month after presentation.


B) The anterior chamber had deepened and the eye was quiet at 8-month follow-up.


(A) Scalp VEEG showed seizure onset with the consciousness loss with head-turning to the left was located on the right anterior area with low-voltage fast activities.


(B) SEEG demonstrated that inter-ictal discharges emerged only within the temporal lobe (nodes A8-11, B6-7, B11-12, D7-9, and E4-5).


(C) SEEG showed that GS started within the right hippocampus (nodes D7-9 and E4-5) with spike-waves in fast activities. Seizure activities were not recorded, either during the inter-ictal period or during the seizure procedure, in nodes within the remaining HH.


Leptomeningeal enhancement demonstrated on MRI with and without contrast of the brain and spinal cord. MRI brain axial image showing leptomeningeal enhancement of the posterior fossa and the visualized proximal spinal cord (A).


Leptomeningeal enhancement demonstrated on MRI with and without contrast of the brain and spinal cord. Leptomeningeal enhancement was noted in sagittal images of the cervical spine.


Leptomeningeal enhancement demonstrated on MRI with and without contrast of the brain and spinal cord. , thoracic spine.


Leptomeningeal enhancement demonstrated on MRI with and without contrast of the brain and spinal cord.lumbar spine Areas of hyperintensity are denoted by the red arrows.


Left side thalamotomy in the Vim line connecting the posterior tips of both the external globus pallidus in the AC-PC plane, 1.5-mm medial from the cerebrospinal tract border.


Right-side thalamotomy in the Vim line connecting the posterior tips of both the external globus pallidus in the AC-PC plane, 1.5-mm medial from the cerebrospinal tract border.


Left-side thalamotomy in the Vim line connecting the posterior tips of both the external globus pallidus in the AC-PC plane, 1.5-mm medial from the cerebrospinal tract border.


Lead and internal pulse generator correctly located after surgery for occipital nerve stimulation.


Surgery for lead repositioning. Dissection of the fibrosis constraining the stress relief loop can be observed.


Repositioned lead after surgery.


A; CT scan of the abdomen and pelvis showing a left renal mass 13 cm in diameter with features suggestive of primary RCC.


MRI of the spine sagittal section showing anterior and posterior parallel thick lines of avid enhancement corresponding to the leptomeninges, which is highly abnormal and indicates leptomeningeal carcinomatosis.


A histopathological exam confirming papillary RCC.


Histopathology. (A) Hematoxylin and eosin stain sections show the cortex with reactive astrocytes.


Histopathology. (B) Perivascular lymphocytic infiltrate.


Histopathology. (C) Luxol fast blue staining for myelin shows no significant myelin loss.


Histopathology. (D) Immunohistochemistry with antiglial fibrillary acidic protein antibody highlights numerous reactive astrocytes. MIB 1 staining showed a proliferation index of less than 1%; p53 was negative (not shown). IDH1/2 mutation was not detected.


MRI of the brain after the lesionectomy. (A) Seven months after onset of EPC, T2 FLAIR sequence shows an area of encephalomalacia over the right frontal cortex in the region of surgery.


MRI of the brain after the lesionectomy. (B) Twelve months after onset of EPC, T2 FLAIR sequence shows stable postsurgical changes over the right frontal cortex in the region of surgery despite the worsening of EPC.


MRI of the brain after the lesionectomy. (C) Twelve months after onset of EPC, T1 postcontrast sequence shows no contrast enhancement around the area of encephalomalacia.


MRI of the brain after the lesionectomy. (D) Two years after onset of EPC, T2 FLAIR sequence shows stable postsurgical changes. In addition, no asymmetric brain volume loss was noted.


Computed tomography (CT) post STN-DBS electrode placement. (a) Axial view at the level of the most proximal (top) electrode contacts.


Computed tomography (CT) post STN-DBS electrode placement. (b) Axial view at level of most distal (bottom) electrode contacts.


Computed tomography (CT) post STN-DBS electrode placement. (c) Coronal view at level of most proximal electrode contact.


Computed tomography (CT) post STN-DBS electrode placement. (d) Coronal view at level of most distal contact.


Computed tomography (CT) post STN-DBS electrode placement. (e) Sagittal view showing right STN electrode.


Computed tomography (CT) post STN-DBS electrode placement. (f) Sagittal view showing left STN electrode contacts.


(A) Laryngoscopic images of laryngeal airway opening. T = True vocal folds; F = False vocal folds; Ep = Epiglottis; Ar = Arytenoids; * = Airway (space between vocal folds).


(B) Schematic representation of vocal fold mobility. (a) True vocal fold adduction during phonation. (b) Vocal fold abduction during normal inspiration. (c) Vocal folds immobile at the paramedian position. (d) The left vocal fold appears immobile at the paramedian position while the right vocal fold is abducted during inspiration. TVC = True vocal cords/folds; FVC = False vocal cords/folds.


Repeat magnetic resonance imaging brain axial images after 3 months showing partial resolution of the previous hyperintense signals in bilateral cerebellar hemispheres:. T1-weighted image.


T2-weighted image.


Fluid-attenuated inversion recovery image.


(a and b) Pre-operative sagittal and axial T1-weighted MRI with gadolinium contrast injection showing the homogenous enhancement by an olfactory groove meningioma.


(c) Immediate post-operative brain CT shows tumor removal and vasogenic brain edema.


(d) Post-operative sagittal T1-weighted MRI with gadolinium contrast reveals near total resection of the tumor.


Atrophic tongue with fasciculation in patient 4.


MRI of the brain with contrast. . Notes: (A) T2WI axial view.


MRI of the brain with contrast. (B) T1WI sagittal view. Both views demonstrate nonspecific dural enhancement. . Abbreviations: MRI, magnetic resonance imaging; T1WI, T1-weighted image; T2WI, T2-weighted image.


T1-weighted sagittal image of a 2-year-old girl. Note the hypoplastic pons and cerebellum with normal appearance of the corpus callosum.


The pedigree of the patients. Open symbols indicate healthy individuals and solid black symbols indicate affected individuals. An arrow indicates the index case.


Electroencephalography trace showing the onset of the ictal rhythm in left temporal lobe with slowing of the heart rate towards the end of the trace.


Electroencephalography trace showing built up of rhythm in left temporal region with progressive slowing of heart rate followed by asystole (16 s).


Electroencephalography trace showing progression of the ictal rhythm and asystole with return of cardiac activity towards the end of trace.


Electroencephalography trace showing further built up of ictal rhythm which is now left hemispheric along with return of normal cardiac rhythm.


(A,B) Plain chest X-rays of cases 1 and 2 showing the upside-down implanted pulse generators (IPGs) but with the extension wires still intact and no evidence of twisting observed. The red arrow means that the r-IPG was upside down.


(A,B) Plain chest X-rays showing that the rechargeable implanted pulse generators (r-IPGs) were inside out. No fracturing or twisting of the leads was observed. The red arrow means that the r-IPG was inside out.


Plain chest X-ray showing the normal view of the implanted pulse generator (IPG) and the extension wire. No fracturing or twisting of the wire was observed and the IPG was in the correct orientation.


Intraoperative figure showing the thickness of the subcutaneous fat layer which is equal to the length of the index finger to the proximal interphalangeal joint.


Follow-up head CT on the day of admission shows extensive SAH as well as an epidural hematoma that required evacuation.


(a) Lateral cerebral angiogram of right ICA injection showing early venous drainage through the right CCF with retrograde filling of the right SOV. Note evidence of vasospasm along the right communicating portion of the ICA and the right M1.


(b) Anterior-posterior cerebral angiogram of left ICA injection showing no flow into the left ACA due to severe vasospasm of the left A1 segment and mild to moderate vasospasm of the left ICA and M1 segment of the left MCA.


(c) Anterior-posterior cerebral angiogram of right ICA injection showing mild vasospasm of the right ICA and M1 segment of the right MCA. There is no evidence of retrograde cortical venous drainage.


Anterior-posterior cerebral angiogram of right ICA injection after left ICA and left cavernous sinus occlusion showing antegrade flow into both anterior circulation. The venous phase on the left was delayed by 1 second compared to the right side. There continues to be evidence of retrograde cortical venous drainage from the right cavernous sinus into the right superficial middle cerebral vein.


(a) Microscope photograph showing the arterialized right superficial middle cerebral vein.


(b) Microscope photograph showing the right superficial middle cerebral vein after it was clipped, cauterized, and cut.


Three-month follow-up anterior-posterior cerebral angiogram of right ICA injection reveals good collateral flow into the left anterior circulation via the Acomm with retrograde flow through the residual left CCF into the cavernous sinus.


Rank-two ellipse seriation-based visualization of correlation matrix before.


After. RTMS treatment. The dotted-black boxes denote the cerebellar network and other connected networks, where the green boxes show the inter-network overlap. Thus, we see that the overlapped region in (
2A) has now transitioned to three different overlapped areas in (
2B), which shows the increase in the overlap between modular networks after treatment. Cerebellar nodes are denoted in black, cortical nodes in blue and subcortical nodes in green. The lesion node (right crus II) and the region of neuro-stimulation are given in red; R2E= Rank-two ellipse.


FMRI results. Differences in the neural activation between dance movements vs. daily movements. Statistical maps are displayed on a standard T1 template. lTH, left thalamus; rSPCg, right superior precentral gyrus; lSPCg, left superior precentral gyrus; rdlPFC, right dorsolateral prefrontal cortex.


Neuroimaging in the child with pontocerebellar hypoplasia type 1. T1-weighted axial.


Neuroimaging in the child with pontocerebellar hypoplasia type 1. T2-weighted axial.


Neuroimaging in the child with pontocerebellar hypoplasia type 1. Sagittal. Magnetic resonance images of the brain show prominent cerebellar folia consistent with cerebellar atrophy. Also note the prominent clava (c).


Intraoperative photo of the left diaphragmatic defect.


Intraoperative photo of the right diaphragmatic injury.


An axial T2 FLAIR image (both arrows) shows bilateral subacute infarct of the thalamus.


(a) Sagittal T2-weighted magnetic resonance imaging (MRI): L4-L5 interspinous ligament degeneration/sclerosis (eg, hypointense streak (arrow) and severe canal stenosis.


(b) Axial T2-weighted MRI upper L5 level: lumbar canal stenosis with severe thecal sac compression/hypertrophied ligamentum flavum/facet arthrosis.


(c) Sagittal noncontrast computed tomography section lumbosacral spine: sclerosis/flattening of spinous processes of L4/L5 (arrow).


(d-f) Axial T1 contrast MR: abnormal ill-defined enhancement - "atypical" Baastrup's disease (arrows).


Erythema rash on the front of the chest.


MRI and CT images of patient with cochlear implant after magnet removal demonstrating various degrees of signal artifact. (a) T1W axial section demonstrates artifact extending to the subcortical white matter of posterior temporal lobe.


MRI and CT images of patient with cochlear implant after magnet removal demonstrating various degrees of signal artifact. (b and c) T2W and SWI sequences, respectively, showing undistorted anatomy of subthalamic nucleus and midbrain structures. Arrows show medial STN borders.


MRI and CT images of patient with cochlear implant after magnet removal demonstrating various degrees of signal artifact. (d) Axial noncontrast CT with normal visualization of fiducial markers on the localizer.


Intraoperative photograph demonstrating the use of a computer monitor to communicate with the patient that has sensorineural hearing loss during DBS surgery.


Merged iCT images with preoperative MRI. (a-c) Left SWI sequences in the axial, sagittal, and coronal planes showing final DBS distal contact location in relation to the original target (yellow).


Merged iCT images with preoperative MRI. (d-f) Right SWI sequences demonstrating final DBS location compared to the target (green).


Enhanced CT scan of the upper abdomen. . Note: The circle and arrow indicate an area of high density, which was diagnosed as an insulinoma on histopathologic examination. . Abbreviation: CT, computed tomography.


(a-c) From left to right; sagittal T2-weighted magnetic resonance image (MRI) scan showing caudal descent of cerebellar tonsils below the foramen magnum, second image showing axial T2-weighted MRI scan with discrete hyperintense lesions on the head of the caudate lobe and the putamen, third image showing corresponding T2 hypointense areas.


MRI images. MRI images (1.5 tesla): (A,B) Sagittal sections in the T1-weighted MRI images: global cerebellar atrophy with a marked enlargement of the subarachnoid space, thinning of cerebellar folds and vermis (arrow) related to diffuse cerebellar atrophy.


MRI images. (C) Axial section in the T1 sequence: cerebral white matter and ventricles without alterations.


NSD1 gene sequencing. Exon 2 sequence of the NSD1 gene (superior: normal; inferior: patient sequence) showing the deletion of adenine (blue arrow) at position 247 (c.247delA), which has an effect on the protein and generates a premature stop codon at amino acid 87 (red box).


Complete ptosis and ophthalmoplegia in the left eye.


T1 and T2-weighted MRI with gadolinium contrast of the brain and orbits. . Notes: Coronal T2-weighted MRI disclosing a 5x9x10 mm abnormal enhancing of the soft tissue in the left superior orbital fissure with mild extension along the anterior aspect of the left cavernous sinus (red arrow).


T1 and T2-weighted MRI with gadolinium contrast of the brain and orbits.an axial T1-weighted MRI disclosing mild edema of the left lateral rectus (red arrow) . Abbreviations: MRI, magnetic resonance imaging. T1, spin-lattice relaxation time; T2, spin-spin relaxation time.


CT scan brain axial image showing well-circumscribed extra-axial midline hypodense lesion in the posterior fossa (arrow).


MRI brain:. Axial.


Sagittal views showing posterior fossa extra-axial well-marginated T1-hypointense.


T2-hyperintense non-enhancing midline cyst with hydrocephalus.


(d) Coronal view shows elongation of the cyst below foramen magnum.


Photomicrograph of the cyst wall demonstrating a thin arachnoid layer lined by discrete nests of meningothelial cells.


Postoperative decreased size of the cyst.


(A,B) Testis, hematoxylin and eosin stain: scarred area with hyalinized tubular Ghosts (lack arrow), increased vascularity and coarse calcifications (red arrow) within tubular profiles. No viable tumor was identified.


(C) Lymph node, hematoxylin and eosin stain: small foci of metastatic GCT with seminomatous component (black arrows) with associated granulomas (red arrow head).


(D) Immunohistochemical reactivity in tumor cells for CD117 support the diagnosis. CD30 (not shown) is negative.


Coronal T2-weighted magnetic resonance image (T2W MRI) shows subtle hypointense signal intensity lesion in the left cavernous sinus lateral to internal carotid artery.


Axial constructive interference steady state (CISS) magnetic resonance image (MRI) showing enlarged left cavernous sinus due to a hypointense signal intensity lesion lateral to internal carotid artery (arrow), lesion is extending anteriorly towards the orbital apex.


Post-gadolinium enhanced T1-weighted magnetic resonance image (T1W MRI) shows intensely enhancing lesion in the left cavernous sinus (arrow) lateral to medially displaced internal carotid artery. Lesion appears larger as compared to T2-weighted (T2W) coronal image [Figure 1].


Post-contrast T1-weighted (T1W) axial magnetic resonance image (MRI) showing homogenous enhancement of the left cavernous sinus lesion (arrow); lesion is seen extending up to orbital apex as shown by constructive interference steady state MRI.


Two crossword puzzles filled in by the patient. A; At baseline.


Two crossword puzzles filled in by the patient. B; After consecutive treatment with 20 mg citalopram per day.


Intraoperative view of extensive scar and fibrosis surrounding the left ulnar digital nerve of the thumb.


Intraoperative view of the left ulnar digital nerve of the thumb after neurolysis.


Intraoperative view of the left ulnar digital nerve of the thumb after neurolysis, with view of the entire left hand.


Intraoperative view of the left ulnar digital nerve of the thumb with AxoGuard Nerve Protector in place.


Heidelberg optic coherence tomography showing optic atrophy in the left eye.


Dilated fundus examination showed diffuse extramacular drusen of the right eye. The macula was flat. There were no choroidal effusions. A; Right eye optic nerve pallor with drusen inferior to the inferior arcade.


Dilated fundus examination showed diffuse extramacular drusen of the right eye. The macula was flat. There were no choroidal effusions. B; More right eye drusen.


Clinical history is summarized in this figure. PMD, paroxysmal movement disorders; EEG, electroencephalography; BCECTS, Benign Childhood Epilepsy with Centro-Temporal Spikes; ESES, Electrical Status-Epilepticus during slow-waves Sleep; SW, spike-and-wave; poly-SW, polyspike-and-wave; HM, hemiplegic migraine; ADHFD, Attention Deficit and Hyperactivity Disorder; VPA, Sodium Valproate; ESM, Ethosuximide; LTG, Lamotrigine.


EEG showed synchronous symmetrical irregular 2.5-3 Hz spike-and-wave sequences, facilitated by hyperventilation, consistent with atypical absence seizure.


Ictal EEG recording during long-term video-EEG monitoring: Generalized spike-wave complex with fronto-central maximum associated with a habitual myoclonic jerk of the right hand during writing. Longitudinal bipolar montage, 50 Hz notch filter, low-pass filter 30 Hz, high-pass filter 1 Hz.


Right arm showing asymptomatic monomorphic erythmatous lesions.


Left arm showing asymptomatic monomorphic erythematous lesion.


A, B) Histopathologic examination of lacrimal gland biopsy revealed lymphoid follicles with germinal center. IgG-positive plasma cells on the lymphoid follicles were visualized by enzyme immunostaining.


C, D) Enzyme immunostaining with an anti-IgG4 antibody revealed IgG-positive plasma cells, accounting for about a half of IgG4-positive cells on the lymphoid follicles.


On admission, antibiotic therapy (cefazolin 2 g/day) was started to treat cellulitis. Non-steroidal anti-inflammatory drugs (loxoprofen 180 mg/day) and benzbromarone were also started to treat polyarthritis with hyperuricemia. After a diagnosis of IgG4 related disorder, oral prednisolone was started at 40 mg/day. After starting oral prednisolone, the clinical symptoms and nerve conduction study findings improved. After discharge, the steroid dose was tapered. But at the time of reducing 3 mg/day of prednisolone dose, both lacrimal gland swelling and gait disturbance reappeared. Serum IgG4 was also elevated. The steroid dose was increased to 10 mg/day and these symptoms improved.


(A) Spontaneous bursts of repetitive spikes with an occipital predominance associated with myoclonic jerks.


(B) EEG showing normal posterior background and a non-sustained photoparoxysmal response associated with multifocal myoclonic jerks following stimulation at 14 Hz.


(A) Fixation off sensitivity.


(B) REM sleep. A peculiar pattern consisting of repetitive spikes over the parasagittal derivations associated with fragmentary minimyoclonus of the right hand.


Preoperative magnetic resonance imaging. The T2-weighted sagittal image (left) shows a large hyperintense retroclival cystic mass extending into interpeduncular and suprasellar cisterns, causing compression and posterior displacement of brain stem.


Preoperative magnetic resonance imaging. The T1-weighted postgadolinium sagittal image (middle) shows a nonenhancing mass.


Preoperative magnetic resonance imaging. Diffusion weighted image (right) demonstrates a mass lesion in interpeduncular cistern without restricted pattern.


Intraoperative transnasal endoscopic view after fenestration of the cyst into adjacent cisterns.


Postoperative magnetic resonance imaging. The T2-weighted axial.


Postoperative magnetic resonance imaging. Sagittal. Images show cyst shrinkage and decompression of brain stem.


Brain stem degeneration presents in brain MRI. Sagittal.


Brain stem degeneration presents in brain MRI. Transversal. T2-weighted brain MRI indicates gliotic neurodegeneration in the medulla oblongata with predominant loss of pyramidal tracts.


Brain stem degeneration presents in brain MRI. Magnification of inlay (c) uncovers pathologic brain stem formation reminiscent of 'kissing swans.


Brain stem degeneration presents in brain MRI. D; Transversal T1-weighted sectioning of the brain stem (arrow) after Gadolinium administration. No contrast enhancement is detectable.


Brain stem degeneration presents in brain MRI. E; Sagittal T2-weighted cervical spine MRI shows atrophy of the upper cervical spinal cord in addition to medulla oblongata atrophy.


Brain stem degeneration presents in brain MRI. F; Transversal T2-weighted brain MRI indicates putative periventricular rim-sign and global brain atrophy.


Brain stem degeneration presents in brain MRI. G; Brain MRI-angiography reveals normal intracranial vascular status without indication of stenosis.


The audiogram reveals sudden senseurineural hearing loss on the right ear.


The audiogram after the treatment shows no improvement.


The audiogram shows spontaneous recovery of the right ear.


Fundus photographs of a 50-year-old woman, who presented with blurry vision in her right eye 12 h after having coronary angiography. (a) Right eye showing a tiny single juxtafoveal whitish patch consistent with an isolated cotton wool spot.


Fundus photographs of a 50-year-old woman, who presented with blurry vision in her right eye 12 h after having coronary angiography. (b) Left eye fundoscopy was unremarkable.


Upward movement restriction in the left eye.


Coronal computed tomography - left orbital floor fracture with entrapment.


Intact infraorbital rim with entrapped orbital content.


(a) Computed tomography, at admission, demonstrating that localized thick clot in the left Sylvian fissure. Note that it comes with perifocal edema.


(b) Preoperative cerebral angiography demonstrating that the left middle cerebral artery and anterior cerebral artery showed evidence of severe vasospasm.


(c) Three-dimensional digital subtraction angiography, operative view, demonstrating that small aneurysm originates from the left sphenoidal segment of middle cerebral artery (M1) - insular segment of middle cerebral artery (M2) bifurcation (arrow). Note that severe vasospasm was observed in M1 (arrow head).


(a) Intraoperative photograph during direct clipping demonstrating that the left M1-M2 bifurcation aneurysm was exposed. A fibrin cap covers the dome of the aneurysm and the source of intra-Sylvian hematoma was determined to be this small aneurysm.


(b) The ruptured aneurysm was occluded with two clips.


(c) After clipping of the aneurysm, spastic vessels were directly applied with nicardipine which was soaked in oxidized cellulose.


(a) Postoperative cerebral angiography, performed just after the direct clipping of the left middle cerebral artery (MCA) aneurysm, demonstrating that the left M1 was completed dilated.


(b) Magnetic resonance angiography (MRA), on the 3rd day of operation, demonstrating that the left MCA showed evidence of vasospasm.


(c) MRA, on the 18th day of the operation, demonstrating no evidence of vasospasm on the left anterior cerebral artery and MCA.


Electrocardiograme demonstrating symmetrical T wave inversions in the anterolateral leads concerning for ischemia.


(A) Coronary angiogram showing left coronary artery circulation with a non-occlusive lesion in proximal left circumflex artery.


(B) Coronary angiogram showing right coronary artery circulation.


(A,B) Left ventriculography demonstrating apical ballooning and hypokinesis of the apex with normal functioning basal inferior and anterior segments.


Intraoperative views (opening of the dura mater, left side), showing the shunt location and the single draining vein (white arrow).


Which is disconnected with bipolar coagulation (black arrow: disconnected vein).


The draining vein is degenerated with shunt disconnection (black dashed arrow) (d).


Optic disc asymmetry of cup-disc ratio 0.6 in the right eye.


0.4 in the left eye.


Optic nerve head topography on HRT.


Optical coherence tomography of the optic nerve head and peripapillary retinal nerve fiber layer. . Note: Both the HRT and optical coherence tomography were normal except for rim area asymmetry noted on HRT. . Abbreviation: HRT, Heidelberg retinal tomograph.


Humphrey visual field of patient's left.


Right. Eyes.


Echocardiography showed characteristic kinetic disturbances in the apical heart region.


Levocardiography in the right anterior oblique position shows the picture of an octopus pot, which is characteristic for Takotsubo cardiomyopathy.


Diagnostic computed tomography angiogram figure description: bony erosion and remodeling of the left sphenoid and petrous temporal bones are seen, related to the mass (a and b).


On contrasted imaging (c), angiography demonstrates external compression (approximately 50% narrowing) of the cavernous and petrous segment of the left internal carotid artery.


Mandibular and muscular atrophy figure description: contrasted T1-weighted magnetic resonance imaging demonstrates asymmetric of the mandibular rami, with left smaller than right, as well as atrophy of the muscles of mastication.


The axial brain fluid-attenuation inversion recovery (FLAIR) images.


Sagittal T2-weighted images , demonstrating a "heart-shaped" appearance area of hyperintensity located in the tegmentum of the caudal midbrain.


(A) The brain diffusion-weighted image (DWI) of the patient is shown. Note the "heart or V"-shaped lesion showing increased intensity in the tegmentum of the caudal midbrain.


(B) The brain apparent diffusion coefficient map MRI (ADC) of the patient is shown. The "heart or V"-shaped lesion shows low intensity on ADC, consistent with acute infarction.


1.5T Brain MRI, axial T2-weighted images.


Coronal T2-weighted images. Shows the symmetric enlargement and increased signal intensity of both inferior olives (arrow).


Results and evolution in z-scores of individual tests - Case 1. IQ, Intelectual quocient; T1, Time 1; T2, Time 2; T3, Time 3.


Results and evolution in z-scores of individual tests - Case 2. IQ, Intelectual quocient; T1, Time 1; T2, Time 2; T3, Time 3.


Stimulation amplitude of adaptive deep brain stimulation (aDBS) and fluctuations in the beta band (16.60 +- 2.5 Hz) oscillation of the local field potential (LFP) over time for a long period.


A short period Arrow in (b) indicates the timing of levodopa 100 mg /carbidopa 25 mg intake. Conventional DBS (cDBS) (outside the hospital): Stimulation was set at 2.2 mA. ADBS (inside and outside the hospital): Upper stimulation was set at 3.5 mA and lower at 0.7 mA. Strength of beta oscillation = Vin (v) * Gain * 16 (LSB) / 1.2 (v) Vin: input voltage to the analog to digital convertor, Gain = 250, LSB of an analog-to-digital convertor is 16 least significant bits, The analog-to-digital convertor has a voltage range of 1.2 v.


Left optic nerve at presentation, showing diffuse swelling.


Normal right optic nerve at presentation.


Two weeks later, right optic nerve showing very pale swelling.