Clinical manifestation and neuroimaging methods in diagnosing basal ganglia calcifications

The aim of this case study was to evaluate the clinical symptoms in patients with basal ganglia calcifications and compare the neuroimaging methods used in confirming this state. The clinical status and performed transcranial sonography of basal ganglia structures in patients with brain calcifications found by computed brain tomography was examined. In one of these patients DaTSCAN was performed. A large spectrum of different symptoms was found. Transcranial sonography of basal ganglia showed the hyperechogenicity of nucleus lenticularis in eight out of 10 patients. DaTSCAN, which was performed to one patient with parkinsonian signs and the hyperechogenicity of substantia nigra found by transcranial sonography, was normal. Transcranial sonography is a newly neuroimaging method which can contribute to diagnosing basal ganglia calcifications in patients with different neurological signs. Computed tomography of brain remains the most adequate technique in visualising calcifications.

Six years of following up a glomus jugulare tumor - a case report

This case report followed up a patient for six years after she had been successfully treated by embolization and gamma knife surgery, while a complete surgical resection was contraindicated because of the high risk of possible mortality outcome. A development of internal hydrocephalus in a subacute postoperative period as a probable postoperative complication related to gamma knife surgery was noted.

Cognitive dysfunction in idiopathic and vascular parkinsonism

AIM

To evaluate the characteristics of cognitive disturbances in patients with parkinsonism and to point out the need of following up those changes by highly specific tests.

METHODS

The first group consisted of patients with Parkinson's disease, and the second group of patients with vascular parkinsonism. The neuropsychological assessments were performed with mini mental state examination (MMSE) and the Raven progressive matrices.

RESULTS

The MMSE has shown a higher percentage of patients with vascular parkinsonism who had dementia. For evaluating the nonverbal possibilities, the aim of understanding the complex situation and the visual perception, the Raven's progressive matrices were used showing that in both groups of the patients those specific changes were highly present.

CONCLUSIONS

It was concluded that MMSE and Raven's progressive matrices have to be obtained in early phases of the disease, and have to be repeated to follow up the therapy effect.

Ultrasound evaluation of extracranial carotid artery lesions in Parkinsonian patients

The purpose of this investigation was to determine the atherosclerotic changes in patients with vascular parkinsonism and in patients with idiopathic Parkinson's disease, in order to evaluate the possible influence of the extracranial pathology of carotid arteries in developing lacunar cerebral infarcts. Degree of stenosis and plaque morphology of the extracranial part of carotids in both group of patients were evaluated by color Doppler flow imaging ultrasound investigation and the results were compared. We selected two matched groups of patients with parkinsonism: 22 patients with vascular parkinsonism, and 28 with idiopathic Parkinson's disease.The atherosclerotic changes found in patients with Parkinson's disease showed mild carotid lesions with mostly stable calcified plaques and lesser risk for embolic cerebral intravascular events contrary to the higher degree of carotid stenosis found in patients with vascular parkinsonism with mostly mixed plaques prone to embolization. Therefore, we suggest performing ultrasonographic examination of the extracranial part of carotid arteries in all patients with parkinsonism to assess risk of vascular accidents originating from carotid lesions. That would enable adequate treatment of parkinsonism and prevent further occurrence of intracranial vascular changes.