15 results on '"A. Mika-Gruettner"'
Search Results
2. Topodiagnostic investigations on the sympathoexcitatory brain stem pathway using a new method of three dimensional brain stem mapping
- Author
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Marx, J.J., Iannetti, G.D., Mika-Gruettner, A., Thoemke, F., Fitzek, S., Vucurevic, G., Urban, P.P., Stoeter, P., Cruccu, G., and Hopf, H.C.
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Brain stem -- Research ,Health ,Psychology and mental health ,Research - Abstract
J Neurol Neurosurg Psychiatry 2004;75:250-255 Objectives: To study the incompletely understood sympathoexcitatory pathway through the human brain stem, using a new method of three dimensional brain stem mapping on the [...]
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- 2004
3. Electrophysiological brainstem testing in the diagnosis of reversible brainstem ischemia
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Marx, Juergen J., Mika-Gruettner, Annette, Thoemke, Frank, Fitzek, Sabine, Fitzek, Clemens, Vucurevic, Goran, Urban, Peter P., Stoeter, Peter, and Hopf, Hanns C.
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- 2002
- Full Text
- View/download PDF
4. Diffusion weighted magnetic resonance imaging in the diagnosis of reversible ischaemic deficits of the brainstem. (Paper)
- Author
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Marx, J.J., Mika-Gruettner, A., Thoemke, F., Fitzek, S., Fitzek, C., Vucurevic, G., Urban, P.P., Stoeter, P., and Hopf, H.C.
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Brain stem ,Cerebral ischemia ,Magnetic resonance imaging ,Health ,Psychology and mental health - Abstract
Methods: A total of 158 consecutive patients presenting with acute signs of brainstem dysfunction were investigated using EPI diffusion weighted MRI within 24 hours of the onset of symptoms. High [...]
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- 2002
5. A new method to investigate brain stem structural–functional correlations using digital post-processing MRI – reliability in ischemic internuclear ophthalmoplegia
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Marx, J. J., Thoemke, F., Fitzek, S., Vucurevic, G., Fitzek, C., Mika-Gruettner, A., Urban, P. P., Stoeter, P., and Hopf, H. C.
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- 2001
6. Diffusionsgewichtetes MRT bei vertebrobasil�ren Isch�mien
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F. Thoemke, Sabine Fitzek, A. Mika-Gruettner, Peter Stoeter, Marianne Dieterich, Peter P. Urban, Goran Vucurevic, H. C. Hopf, and Jürgen Marx
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medicine.medical_specialty ,business.industry ,Infarction ,Signs and symptoms ,General Medicine ,medicine.disease ,Mr imaging ,Acute ischemia ,Surgery ,Psychiatry and Mental health ,Neurology ,Vertebrobasilar ischemia ,Medicine ,Cerebellar infarction ,In patient ,cardiovascular diseases ,Neurology (clinical) ,Radiology ,Ct imaging ,business - Abstract
The aim of this study was to evaluate the applicability, sensitivity, and predictive power of diffusion-weighted MR imaging (DWI) in the diagnosis of vertebrobasilar infarction. From 1997 to 2002, we prospectively recruited 268 patients with acute signs and symptoms suspective of vertebrobasilar ischemia. The patients underwent biplanar EPI-T2 and EPI DWI within 24 h after onset of symptoms and high-resolution MRI as a control within 7 days. One hundred twenty-one patients had additional CT scanning. The DWI revealed acute vertebrobasilar infarction in 71.0%. The mean time exposure of DWI was 8 min and thus no more than that of CT imaging. It showed significantly more acute lesions than CT imaging (28.0%), but additional high-resolution MRI was not able to reveal more lesions than DWI alone. Even in 42 patients with reversible brainstem or cerebellar symptoms classified as TIA or PRIND, DWI demonstrated acute ischemia in 42.8%. Sixty-three patients with optimal final diagnosis of vertebrobasilar ischemia had normal DWI. One week after onset of symptoms, 88.9% of these patients had recovered completely or showed minimal symptoms. Therefore, DWI is a sensitive indicator of acute vertebrobasilar ischemia. It is no more time-consuming than CT imaging, and normal DWI is a predictor of good clinical outcome in patients with brainstem or cerebellar infarction.
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- 2004
7. A new method to investigate brain stem structural-functional correlations using digital post-processing MRI - reliability in ischemic internuclear ophthalmoplegia
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F. Thoemke, Clemens Fitzek, H. C. Hopf, A. Mika-Gruettner, Goran Vucurevic, Jürgen Marx, Peter P. Urban, Sabine Fitzek, and Peter Stoeter
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Internuclear ophthalmoplegia ,Anatomical structures ,Lesion ,Image Processing, Computer-Assisted ,medicine ,Humans ,Aged ,Brain Mapping ,Ophthalmoplegia ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Eye movement ,Magnetic resonance imaging ,Anatomy ,Middle Aged ,Medial longitudinal fasciculus ,medicine.disease ,Magnetic Resonance Imaging ,Electrooculography ,Electrophysiology ,Neurology ,Slice selection ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Brain Stem - Abstract
We investigated the reliability of a new digital post-processing magnetic resonance imaging (MRI) technique in ischemic brain stem lesions to identify relations of the lesion to anatomical brain stem structures. The target was a medial longitudinal fasciculus (MLF) lesion, which was evident from ipsilateral internuclear ophthalmoplegia (INO). Sixteen patients with acute unilateral INO and an isolated acute brain stem lesion in T2- and EPI-diffusion weighted MRI within 2 days after the onset of symptoms were studied. The MRI slice direction was parallel and perpendicular to a slice selection of a stereotactic anatomical atlas. The individual slices were normalized and projected in the digitalized atlas. The eye movement disorder was monitored by electro-oculography. In all patients with clinical or subclinical electro-oculographically documented INO and MRI proven brain stem infarction the lesion covered or at least partially overlapped the ipsilateral MLF at one or more atlas levels. We conclude that digital post-processing MRI with normalizing and projecting brain stem lesions in an anatomical atlas is a reliable method to demonstrate the anatomical structures involved by the lesion. Combined with electrophysiological brain stem testing, this method may be a useful tool to identify incompletely understood pathways mediating brain stem reflexes or the generators of evoked potentials.
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- 2001
8. [Diffusion-weighted MRT in vertebrobasilar ischemia. Application, sensitivity, and prognostic value]
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J J, Marx, F, Thoemke, A, Mika-Gruettner, S, Fitzek, G, Vucurevic, P P, Urban, P, Stoeter, M, Dieterich, and H C, Hopf
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Adult ,Aged, 80 and over ,Male ,Radiography ,Diffusion Magnetic Resonance Imaging ,Vertebrobasilar Insufficiency ,Humans ,Reproducibility of Results ,Female ,Middle Aged ,Prognosis ,Sensitivity and Specificity ,Aged - Abstract
The aim of this study was to evaluate the applicability, sensitivity, and predictive power of diffusion-weighted MR imaging (DWI) in the diagnosis of vertebrobasilar infarction. From 1997 to 2002, we prospectively recruited 268 patients with acute signs and symptoms suspective of vertebrobasilar ischemia. The patients underwent biplanar EPI-T2 and EPI DWI within 24 h after onset of symptoms and high-resolution MRI as a control within 7 days. One hundred twenty-one patients had additional CT scanning. The DWI revealed acute vertebrobasilar infarction in 71.0%. The mean time exposure of DWI was 8 min and thus no more than that of CT imaging. It showed significantly more acute lesions than CT imaging (28.0%), but additional high-resolution MRI was not able to reveal more lesions than DWI alone. Even in 42 patients with reversible brainstem or cerebellar symptoms classified as TIA or PRIND, DWI demonstrated acute ischemia in 42.8%. Sixty-three patients with optimal final diagnosis of vertebrobasilar ischemia had normal DWI. One week after onset of symptoms, 88.9% of these patients had recovered completely or showed minimal symptoms. Therefore, DWI is a sensitive indicator of acute vertebrobasilar ischemia. It is no more time-consuming than CT imaging, and normal DWI is a predictor of good clinical outcome in patients with brainstem or cerebellar infarction.
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- 2004
9. Electrophysiological brainstem testing in the diagnosis of reversible brainstem ischemia
- Author
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A. Mika-Gruettner, Clemens Fitzek, Sabine Fitzek, F. Thoemke, Peter Stoeter, Hanns Christian Hopf, Peter P. Urban, Goran Vucurevic, and Juergen J. Marx
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Neurology ,Ischemia ,Sensitivity and Specificity ,Internal medicine ,otorhinolaryngologic diseases ,medicine ,Humans ,Corneal reflex ,Prospective Studies ,Evoked potential ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,Blinking ,business.industry ,Electromyography ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Evoked Potentials, Motor ,Magnetic Resonance Imaging ,Electrooculography ,Ischemic Attack, Transient ,Cardiology ,Reflex ,Evoked Potentials, Auditory ,Female ,Neurology (clinical) ,Brainstem ,business ,Jaw jerk reflex - Abstract
The aim of this study was to evaluate the sensitivity of multimodal electrophysiological brainstem testing in the diagnosis of clinically suspected reversible ischemic deficits of the brainstem compared with diffusion weighted MR imaging. We investigated 158 consecutive patients presenting with signs of acute brainstem dysfunction. Serial electrophysiological brainstem tests including masseter reflex, blink reflex, masseter inhibitory reflex, AEP, MEP, EOG and the oculoauricular phenomenon were applied. In 14 of the 158 patients neurological deficits resolved in less than 24 hours, which was suggestive of a transitory ischemic attack (TIA), 19 patients had brainstem signs for more than 24 hours but less than 1 week, suggestive of a reversible ischemic neurological deficit (RIND). Electrophysiological data indicated acute functional brainstem lesions in 54,5 % of patients with transient clinical brainstem impairment. Lesion detection rate was significantly higher when combining electrophysiological data and MRI (60,4 %) than using acute brainstem abnormalities in diffusion weighted MRI alone (39,4 %). We conclude that diffusion weighted MRI and electrophysiological brainstem testing are complimentary sensitive indicators of acute brainstem lesions in patients with reversible neurological deficits. Correct identification of brainstem ischemia influences the therapeutic regimen and may improve patient outcome.
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- 2002
10. Diffusion weighted magnetic resonance imaging in the diagnosis of reversible ischaemic deficits of the brainstem
- Author
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Clemens Fitzek, Sabine Fitzek, H. C. Hopf, F. Thoemke, Peter Stoeter, Peter P. Urban, Jürgen Marx, A. Mika-Gruettner, and Goran Vucurevic
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Adult ,Male ,Paper ,medicine.medical_specialty ,Ischemia ,Sensitivity and Specificity ,Central nervous system disease ,Diagnosis, Differential ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Stroke ,Aged ,Aged, 80 and over ,Neurologic Examination ,Vascular disease ,business.industry ,Middle Aged ,medicine.disease ,equipment and supplies ,Magnetic Resonance Imaging ,Diffusion-Weighted Magnetic Resonance Imaging ,Surgery ,Psychiatry and Mental health ,Editorial Commentary ,Ischemic Attack, Transient ,Acute Disease ,Cardiology ,Female ,Neurology (clinical) ,Brainstem ,T2 weighted ,business ,human activities ,Diffusion MRI ,Brain Stem - Abstract
Objectives: To evaluate the sensitivity of diffusion weighted magnetic resonance imaging (MRI) for the diagnosis of clinically suspected reversible ischaemic deficits of the brainstem. Methods: A total of 158 consecutive patients presenting with acute signs of brainstem dysfunction were investigated using EPI diffusion weighted MRI within 24 hours of the onset of symptoms. High resolution T1 and T2 weighted imaging was performed as a follow up after a median of six days Results: Fourteen of the 158 patients had a complete clinical recovery within 24 hours (transitory ischaemic attack (TIA)), and 19 patients recovered in less than one week (prolonged reversible neurological deficit (RIND)). Diffusion weighted MRI showed acute ischaemic deficits in 39% of patients with transient neurological deficits. The detection rate seemed to be higher in patients with longer lasting symptoms, but the difference between patients with TIA (29%) and RIND (47%) was not significant. Conclusions: Diffusion weighted MRI is a sensitive indicator of acute ischaemic brainstem deficits even in patients with reversible neurological deficit. Early identification of patients with TIA and increased risk of stroke may influence acute management and improve patient outcome.
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- 2002
11. Topodiagnostic value of blink reflex R1 changes: a digital postprocessing MRI correlation study
- Author
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Juergen J. Marx, Peter P. Urban, Sabine Fitzek, Goran Vucurevic, A. Mika-Gruettner, Peter Stoeter, Clemens Fitzek, F. Thoemke, and Hanns Christian Hopf
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Adult ,Male ,Brain Stem Infarctions ,Physiology ,Cellular and Molecular Neuroscience ,Physiology (medical) ,medicine ,Image Processing, Computer-Assisted ,Humans ,Corneal reflex ,Aged ,Trigeminal nerve ,Aged, 80 and over ,medicine.diagnostic_test ,Blinking ,Reflex arc ,Spinal trigeminal nucleus ,Magnetic resonance imaging ,Anatomy ,Middle Aged ,Medial longitudinal fasciculus ,Magnetic Resonance Imaging ,Pons ,Electric Stimulation ,medicine.anatomical_structure ,Female ,Neurology (clinical) ,Brainstem ,Psychology ,Brain Stem - Abstract
The aim of the study was to investigate the relation of the blink reflex R1 arc to known anatomical brainstem structures. Acute vascular brainstem lesions as identified by magnetic resonance imaging (MRI) of patients with isolated R1 pathology were superimposed into a stereotactic anatomical atlas using a new method of digital postprocessing. Isolated acute brainstem lesions were documented by diffusion-weighted MRI in 12 of 24 patients with unilateral R1 pathology. The lesions were located in the ipsilateral mid- to lower pons. In three patients only, the lesion had partial contact with the principal sensory nucleus of the trigeminal nerve (PSN) on at least one level. In two patients, the lesion involved the medial longitudinal fasciculus. Most lesions were located medially and ventrally to the PSN on transverse slices. Our results underline the high localizing value of changes in the R1 component of the blink reflex in patients with ipsilateral pontine functional deficits. Although available physiological evidence suggests that the R1 component of the blink reflex traverses an oligosynaptic pathway, this MRI study does not support the view that synaptic transmission in the PSN subserves R1. The reflex arc probably descends more medially and ventrally on its course to the facial nucleus. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 1327–1331, 2001
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- 2001
12. Topodiagnostic value of blink reflex R1 changes: a digital postprocessing MRI correlation study.
- Author
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Marx, Juergen J., Thoemke, Frank, Fitzek, Sabine, Vucurevic, Goran, Fitzek, Clemens, Mika-Gruettner, Annette, Urban, Peter P., Stoeter, Peter, Hopf, Hanns C., Marx, J J, Thoemke, F, Fitzek, S, Vucurevic, G, Fitzek, C, Mika-Gruettner, A, Urban, P P, Stoeter, P, and Hopf, H C
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- 2001
- Full Text
- View/download PDF
13. Diffusion-weighted magnetic resonance tomography in vertebrobasilar ischemia—application, sensitivity, and prognostic value
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Marx, J. J., primary, Thoemke, F., additional, Mika-Gruettner, A., additional, Fitzek, S., additional, Vucurevic, G., additional, Urban, P. P., additional, Stoeter, P., additional, Dieterich, M., additional, and Hopf, H. C., additional
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- 2004
- Full Text
- View/download PDF
14. Diffusionsgewichtetes MRT bei vertebrobasilären Ischämien.
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J. J. Marx, F. Thoemke, A. Mika-Gruettner, S. Fitzek, G. Vucurevic, P. P. Urban, P. Stoeter, M. Dieterich, and H. C. Hopf
- Abstract
Zusammenfassung Ziel der Untersuchung war die Evaluierung der Anwendbarkeit, Sensitivität und möglichen prädiktiven Aussagekraft der diffusionsgewichteten Sequenzen der Magnetresonanztomographie ( DWI diffusion weighted imaging) bei Patienten mit akuten vertebrobasilären Infarkten. Zwischen 1997 und 2002 wurden prospektiv 268 konsekutive Patienten mit akuten, auf eine vertebrobasiläre Ischämie verdächtigen Symptomen rekrutiert. Die Patienten erhielten eine echoplanare (EPI) T2- und EPI-diffusionsgewichtete MRT innerhalb von 24 h nach Beginn der Symptomatik und hochauflösende MRT innerhalb von 7 Tagen, davon 121 Patienten zusätzliche CT-Bildgebung. Im DWI ließ sich ein akuter vertebrobasilärer Infarkt bei 71,0% der Patienten nachweisen. Die mittlere Dauer für die DWI-Untersuchung betrug mit 8 min nicht länger als für eine CCT. In DW-Sequenzen zeigten sich signifikant mehr akute Läsionen als im CT (28,0%), im hochauflösenden MRT jedoch nicht mehr als im DWI alleine. Bei 42 Patienten mit TIA oder PRIND zeigten sich im DWI bei 41,8% akute Diffusionsstörungen. Bei 63 Patienten mit der wahrscheinlichsten Diagnose vertebrobasiläre Ischämie war das DWI unauffällig. Eine Woche nach dem Ereignis zeigten 88,9% dieser Patienten eine vollständige Remission oder nur minimale Restsymptomatik. DWI ist damit ein sensitiver Indikator für akute Infarkte im Versorgungsgebiet des hinteren Kreislaufs. Der zeitliche Aufwand ist vergleichbar dem einer CT und ein unauffälliges DWI kann als Prädiktor eines guten klinischen Outcomes bei Patienten mit Ischämien im Hirnstamm und Zerebellum gewertet werden. [ABSTRACT FROM AUTHOR]
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- 2004
15. Topodiagnostic investigations on the sympathoexcitatory brain stem pathway using a new method of three dimensional brain stem mapping
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Marx, J. J., Giandomenico Iannetti, Mika-Gruettner, A., Thoemke, F., Fitzek, S., Vucurevic, G., Urban, P. P., Stoeter, P., Cruccu, G., and Hopf, H. C.
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Paper ,Aged, 80 and over ,Male ,Brain Diseases ,Brain Mapping ,Imaging, Three-Dimensional ,Sympathetic Nervous System ,Neural Pathways ,Humans ,Female ,Middle Aged ,Aged ,Brain Stem - Abstract
To study the incompletely understood sympathoexcitatory pathway through the human brain stem, using a new method of three dimensional brain stem mapping on the basis of digitally postprocessed magnetic resonance imaging (MRI).258 consecutive patients presenting with acute signs of brain stem ischaemia underwent biplane T2 and EPI diffusion weighted MRI, with slice orientation parallel and perpendicular to a transversal slice selection of the stereotactic anatomical atlas of Schaltenbrand and Wahren, 1977. The individual slices were digitally normalised and projected onto the appropriate slices of the anatomical atlas. For correlation analysis lesions were imported into a three dimensional model of the human brain stem.31 of the 258 patients had Horner's syndrome caused by acute brain stem ischaemia. Only four of the patients with Horner's syndrome had pontine infarctions, 12 had pontomedullary lesions, and 15 had medullary lesions. Correlation analysis showed significantly affected voxels in the dorsolateral medulla but not in the pons. A statistical comparison with infarct topology in patients with medullary lesions but without Horner's syndrome indicated that involvement of the medial and ventral part of affected voxels located in the ventrolateral medullary tegmentum was specific for Horner's syndrome.Based on this first in vivo topodiagnostic study, the central sympathoexcitatory pathway probably descends through the dorsal pons before converging on specific generators in the ventrolateral medullary tegmentum at a level below the IX and X nerve exits.
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