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Objectives: There is evidence that the inflammatory demyelinating disorder in Multiple Sclerosis (MS) is associated with acute seizures and epilepsy. Additionally, the likelihood of developing epilepsy increases with neurodegeneration. This study aims to reveal the clinical and radiological features of MS-epilepsy/seizure coexistence., Methods: Among all patients diagnosed with MS that we followed in our center between April 2002 and July 2023, patients with a single seizure history or diagnosed with epilepsy (MS-seizure/epilepsy) were randomized 1:1 in terms of age and gender with MS patients without a diagnosis of epilepsy or seizures. Clinical (comorbidities, annualized relapse rate, disability, seizures during attacks, initial diagnosis, disease duration, disease-modifying therapies (DMTs), refractory epilepsy, anti-seizure drugs), electroencephalography (EEG) and MRI (lesion localization and new lesion(s)) data were retrospectively evaluated., Results: The mean EDSS was 4.07±2.81. 29.4 % of patients had progressive MS (n = 10). Refractory epilepsy was 52.9 % (n = 18), and SE history was 14.7 % (n = 5). Pathology was detected in 69.7 % (n = 23) of patients in the EEG. The most common slow wave activation was detected in 51.5 % (n = 17). Refractory epilepsy was more common in cases under 45 and patients with lesions in thalamic localization. Lesions in the temporal and thalamic regions and cerebral atrophy were more common in the MS-seizure/epilepsy group., Conclusion: Patients with demyelinating lesions in the temporal and thalamic regions should be questioned more carefully for epilepsy, and an EEG should be performed in case of clinical suspicion. Since thalamus lesions are more common in patients with refractory epilepsy, anti-seizure treatment strategies should be applied more carefully. The presence of atrophy on MRI confirms the link between neurodegeneration processes and the development of epilepsy., Competing Interests: Declaration of competing interest No conflict interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Total resection of glioblastoma (GB) tumors is nearly impossible, and systemic administration of temozolomide (TMZ) is often inadequate. This study presents a hybrid layered composite nanofiber mesh (LHN) designed for localized treatment in GB tumor bed. The LHN, consisting of polyvinyl alcohol and core-shell polylactic acid layers, was loaded with TMZ and rutin. In vitro analysis revealed that LHN TMZ and LHN rutin decelerated epithelial-mesenchymal transition and growth of stem-like cells, while the combination, LHN TMZ +rutin , significantly reduced sphere size compared to untreated and LHN TMZ -treated cells ( P < 0.0001). In an orthotopic C6-induced GB rat model, LHN TMZ +rutin therapy demonstrated a more pronounced tumor-reducing effect than LHN TMZ alone. Tumor volume, assessed by magnetic resonance imaging, was significantly reduced in LHN TMZ +rutin -treated rats compared to untreated controls. Structural changes in tumor mitochondria, reduced membrane potential, and decreased PARP expression indicated the activation of apoptotic pathways in tumor cells, which was further confirmed by a reduction in PHH3, indicating decreased mitotic activity of tumor cells. Additionally, the local application of LHNs in the GB model mitigated aggressive tumor features without causing local tissue inflammation or adverse systemic effects. This was evidenced by a decrease in the angiogenesis marker CD31, the absence of inflammation or necrosis in H&E staining of the cerebellum, increased production of IFN-γ, decreased levels of interleukin-4 in splenic T cells, and lower serum AST levels. Our findings collectively indicate that LHN TMZ +rutin is a promising biocompatible model for the local treatment of GB., Competing Interests: The authors declare no conflicts of interest., (© 2024 Shenyang Pharmaceutical University. Published by Elsevier B.V.)

Background: Fat quantification methods in magnetic resonance imaging (MRI) have been studied to differentiate bone marrow pathologies in adult patients; however, scarce literature is available in pediatric patients., Purpose: To evaluate the efficacy of the T1 signal intensity value (T1-SIV), out-of-phase/in-phase signal ratio (OP/IP SR), and fat fraction (FF) to differentiate between normal, benign, and malignant pathological processes., Material and Methods: A total of 48 pediatric patients with lumbar and pelvic MRI were classified into three groups according to bone marrow pathology (group 1, normal; group 2, benign pathology/reconversion; group 3, malignant). The efficacy of T1-SIV, OP/IP SR, and FF values in differentiating these pathologies was evaluated using Kruskal-Wallis or analysis of variance and followed by Bonferroni or Dunn-Bonferroni tests. Cutoff values for malignant infiltration were defined using ROC analysis., Results: Although these values were significantly different in all three groups ( P  = 0.001-0.008), this difference was not sufficient to discriminate between all groups. Subgroup analyses showed significant differences in T1-SIV between groups 1-3, in OP/IP SR between groups 1-3, 2-3, and 1-2, in FF between groups 1-2 and 1-3 in various regions ( P  = 0.001-0.049). Cutoff values had a sensitivity and specificity of 90%-100% for OP/IP SR and FF., Conclusion: T1-SIV, OP/IP SR, and FF may potentially distinguish normal from pathological bone marrow. OP/IP SR and FF values detected malignant infiltration with high sensitivity and specificity in this study. However, only OP/IP SR may significantly differentiate benign and malignant bone marrow pathologies which needs to be confirmed in the future study with a larger patient population., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Cerebral venous sinus thrombosis (CVST) is a cerebrovascular disease characterized by thrombosis of the cerebral venous or dural sinuses. Autoimmune diseases (AD) are important causes of CVST. This study aims to reveal the differences between CVST associated with autoimmune diseases compared with other causes (OCs) and Behcet's syndrome (BS) compared with other ADs., Methods: This is a single-center retrospective study in which the medical records of 187 patients we followed with a diagnosis of CVST between 2008 and 2023 were collected retrospectively. Four neurologists collected data on initial symptoms, neurological examinations, and laboratory findings. Findings on magnetic resonance imaging and magnetic resonance venography performed on all patients (thrombosis localizations, hemorrhagic or ischemic complications, and collateralization) were re-evaluated by 2 radiologists. The results were compared with AD, other ADs, and OCs groups., Results: There were 28 cases of CVST associated with AD. Of these, 18 were BS, and 10 were other AD. Subacute-chronic onset, headache, and transverse sinus involvement were more common in AD-related patients than in OCs. However, collateralization, venous infarction, hemorrhagic transformation, and bleeding were less common. BS-related patients had earlier age, more frequent transverse sinus, less frequent cortical vein thrombosis, and better collateralization than other ADs., Conclusion: CVST is one of the rare complications in autoimmune diseases. It has a more subacute-chronic onset. Since headaches are more common, it is essential to make a differential diagnosis of CVST in autoimmune diseases with chronic headaches. Transverse sinus thrombosis is more common. Collateralization, venous infarction, and hemorrhagic transformation are less., Competing Interests: The authors have no conflict of interest to declare., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Many different pathologies may underlie tumefactive demyelinating lesions. Identifying clinical and radiologic distinguishing features before pathologic examination is essential for diagnosis and treatment. In this study, we aimed to determine the clinical and radiologic features affecting the etiology and disease course of patients with tumefactive lesions (TDL)., Materials and Methods: We included 35 clinicoradiologically or histologically diagnosed TDL patients in our center over 11 years. Patient records were retrospectively evaluated and recorded. Clinical features, cerebral neuroimaging, and histologic biopsy preparations, if any, were assessed by three independent neurologists, two neuroradiologists, and two pathologists at admission and follow-up, respectively., Results: The mean age of patients with TDL was 40.02±14.40 years. Symptom onset was 15 (1-365) days. The most common complaints at initial presentation were hemiparesis or hemiplegia, sensory complaints, and cognitive impairment (aphasia or apraxia). The lesions were most commonly localized in the frontal lobe (42.9 %). Mass effect was 17.1 %, edema 60 %, diffusion restriction 62.1 %, and contrast enhancement 71.9 % (mostly ring-shaped (68.8 %)) on MR images. Acute onset and OCB type-2 positivity were associated with MS diagnosis. On the other hand, CSF protein levels above 45 mg/dL were found to be related to non-MS etiologies. Only the predominance of aphasia or apraxia at onset was a risk factor for early high disability (EDSS>4; 3rd month). Subacute-chronic onset, being older than 40 years, or having brainstem symptoms at onset were independent risk factors for late high disability (2nd year)., Conclusion: Acute onset or OCB type 2 positivity is a clue for early diagnosis of MS, while elevated CSF protein is a clue for demyelinating diseases other than MS. Presentation with cognitive dysfunction at onset is an independent risk factor for early disability, while age above 40 years, subacute-chronic presentation and brainstem findings at presentation are independent risk factors for late disability., Competing Interests: Declaration of competing interest There is no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

Background: The pulmonary artery area (PAA) is a valuable non-invasive method for the diagnosis of pulmonary hypertension., Purpose: To compare the change in PAA in patients with COVID-19 with the computed tomography (CT) severity index using follow-up imaging., Material and Methods: A total of 81 patients who were followed up and underwent CT assessment more than once at our hospital's pandemic department were evaluated retrospectively. Patients with progression were separated into three groups: progression ranging from mild-to-mild infiltration (Group A, CT severity index of 0-2); progression from mild to severe infiltration (Group B, CT severity index of 0-2 to 3-5); and progression from severe-to-severe infiltration (Group C, CT severity index of 3-5). The PAAs were calculated separately., Results: The mean age was 56 ± 12 years. In terms of those patients showing progression in the CT images, the number of patients in Groups A, B, and C was 29, 40, and 12 in the right lung; 32, 45, and 4 in the left lung; 23, 45, and 13 on both lungs, respectively. There was no significant difference between the main, right, and left PAAs in Group A ( P  > 0.05). In Group B, there were significant increases in the areas of the main, right, and left PAAs ( P  < 0.05). There were also significant increases in the areas of the right and main pulmonary arteries in Group C ( P  < 0.05)., Conclusion: PAAs increase as disease involvement advances in cases with COVID-19 pneumonia, which is thought to be correlated with progression.

Purpose: To investigate possible relationships between the presence and location of arterial transit artifacts (ATA) and clinical symptoms, digital subtraction angiography (DSA), and dynamic susceptibility contrast (DSC) perfusion imaging abnormalities in patients with carotid artery stenosis (CAS)., Methods: Forty-seven patients who underwent arterial spin labeling (ASL) and DSC perfusion imaging in the same period diagnosed with > 50% unilateral internal carotid artery (ICA) stenosis by DSA performed 24 h after perfusion imaging were included. The presence of ATA, localization and hypoperfusion were evaluated using ASL interpretation. Maps derived from DSC perfusion, symptomatology, stenosis rates, and collateralization findings observed in DSA were investigated. Probable relationships were evaluated., Results: ATA on ASL were detected in 68.1% (32/47); 40.6% (13/32) of ATAs were observed in the distal middle cerebral artery (MCA) trace, 50% (16/32) in the intracranial ICA and MCA traces, and 9.4% (3/32) in the intracranial ICA trace. When classifications based on the ATA presence and localization was made, qualitative and quantitative CBF, MTT, and TTP abnormalities, symptomatology, stenosis rates, and collateralization findings significantly differed between groups (p < 0.05)., Conclusion: The presence and localization of ATA in patients with CAS may provide essential insights into cerebral hemodynamics and the CAS severity. ATAs observed only in the distal MCA trace may represent early-stage perfusion abnormalities and a moderate level of stenosis. ATA in the ICA trace may related to a more advanced level of perfusion abnormalities, critical stenosis rates, symptom or collateralization presence., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Most of the corpus callosum (CC) developmental studies are concerned with its two-dimensional structure. Linear and area measurements do not directly assess the CC size but estimate the overall structure from the cross-sectional image. This study investigated age- and sex-related changes in volumetric development and asymmetry of CC from birth to 18. For this retrospective study, we selected 696 patients (329 [47.27%] females) with both 3D-T1-weighted sequence and normal radiological anatomy from patients 0-18 years of age who had brain magnetic resonance imaging (MRI) between 2012 and 2020. The genu, body, splenium, and total volume of CC were calculated using MRICloud. The measurement results of 23 age groups were analyzed with SPSS (ver.28). Total CC volume was 18740.76 ± 4314.06 mm 3 between 0 and 18 years of age, and its ratio to total brain volume (TBV) was 1.70% ± 0.23%. We observed that the total CC volume has six developmental periods 0 years, 1, 2-4, 5-9, 10-16, and 17-18 years. Genu and body grew in five developmental periods, while splenium in seven. There was intermittent sexual dimorphism in the CC volume in the first 4 years of life (p < 0.05). However, sex factor was insignificant in CC ratio to TBV. Total CC was right lateralized on average 1.81% (ranging -0.59% to 4.52%). Genu was 8.70% lateralized to the right, the body was 2.99% to the left, and the splenium was 1.41% to the right. The three-dimensional development of CC agreed with the two-dimensional developmental data of CC except for some differences., (© 2022 American Association of Clinical Anatomists and British Association of Clinical Anatomists.)

Background: Cerebral venous sinus thrombosis (CVST) is not as well understood as an ischemic stroke of arterial origin. Although the prognosis of CVST is usually good, parenchymal lesions may occur in some patients, and the development of intracranial herniation may result in death. For this reason, recognizing the risk factors for intracranial herniation and accurately determining those patients who should undergo decompressive craniectomy is important., Objective: This study aims to determine the risk factors for intracranial herniation in patients with CVST., Methods: A total of 177 patients diagnosed with CVST between 2015 and 2021 in our tertiary center were retrospectively included in this study., Results: Of the 177 patients, 124 were female and 53 were male with mean ages of 40.65 ± 13.23 and 44.13 ± 17.09, respectively. Among those, 18 patients had developed intracranial herniation. A significant statistical relationship was observed between superior sagittal sinus thrombosis, sinus rectus thrombosis, venous collateral score, nonhemorrhagic venous infarct, presence of malignancy, small juxtacortical hemorrhage, and cortical vein thrombosis. The binary logistic regression analysis results showed that the most significant variables were the venous collateral score of 0, malignancy, and small juxtacortical hemorrhages., Conclusion: This study identified small juxtacortical hemorrhages, the presence of malignancy, and a venous collateral score of 0 to be independent risk factors for intracranial herniation in CVST patients. Drawing on these results, we recommend close clinical observation of CVST patients, as they may be candidates for decompressive craniectomy., Competing Interests: The authors have no conflict of interest to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).)

Background: Cancellations of surgeries for elective cases and late admissions of symptomatic cases during the pandemic period might have increased the number of cases of acute cholecystitis and its complications., Purpose: To compare the severity of acute cholecystitis and complication rates during the pandemic and pre-pandemic periods., Material and Methods: We evaluated the computed tomography (CT) findings observed for the diagnosis of complications for both acute simple and acute complicated cholecystitis during both the pandemic and pre-pandemic periods. Patients admitted to the hospital between March 2020 and December 2020 made up the study group and the corresponding appropriate patients from one year earlier were studied as the control group. In addition to the CT findings, clinical and laboratory findings, co-morbidities such as diabetes, as well as the admission time to hospital from the onset of the initial symptoms to hospital admission were also evaluated., Results: A total of 88 patients were evaluated (54 in the study group, 34 in the control group; mean age = 64.3 ± 16.3 years). The male-to-female ratio was 51/37. The number of patients diagnosed with complicated cholecystitis were significantly higher in the study group ( P = 0.03). Murphy finding and diabetes status were similar between the two groups ( P  = 0.086 and P  = 0.308, respectively). Admission time to the hospital was significantly different for study and control groups in simple cholecystitis patients ( P = 0.045); with no significant difference in cases of complicated cholecystitis ( P = 0.499)., Conclusion: Our study reveals the course of acute cholecystitis during the pandemic period was much more serious with higher complications.

Background: Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available., Objective: To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus., Materials and Methods: For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23)., Results: Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm 3 ., Conclusion: This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To determine the importance of serum prolactin (PRL) in the detection of pituitary stalk interruption syndrome (PSIS) in children with multiple pituitary hormone deficiency (MPHD). We hypothesized that PRL elevation might be a diagnostic indicator of pituitary stalk pathologies., Methods: Clinical, radiological, and laboratory features of the 50 cases of MPHD were studied., Results: The median age at presentation of the 50 cases (52%, n=26 were female) was 6.61 (0.02-18.9) years. PSIS was detected in 60% (n=30), pituitary hypoplasia in 32% (n=16), partial empty sella in 6% (n=3), and only 2% (n=1) was reported as normal. Out of 50 patients, 21.3% (n=10) were hypoprolactinemic, 44.7% (n=19) were normoprolactinemic, and 34% (n=16) were hyperprolactinemic. The median PRL value was 27.85 (4.21-130) ng/mL in patients with PSIS and 5.57 (0-41.8) ng/mL in patients without PSIS. Additional hormone deficiencies, especially ACTH and LH were detected in follow-up., Conclusions: Patients with normal or high prolactin levels deserve special attention regarding the possibility of PSIS. Furthermore, we emphasize the importance of regular follow-up and monitoring for multiple pituitary hormone deficiencies in all patients with a single pituitary hormone deficiency., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

This study investigated age- and sex-related changes in the volumetric development and asymmetry of the normal hypothalamus from birth to 18. Individuals aged 0-18 with MRI from 2012 to 2020 were selected for this retrospective study. Seven hundred individuals (369 [52.7%] Males) who had 3D-T1 sequences and were radiologically normal were included in the study. Hypothalamus volume was calculated using MRICloud automated segmentation pipelines. Hypothalamus asymmetry was calculated as the difference between right and left volumes divided by the mean (in percent). The measurement results of 23 age groups were analyzed with SPSS (ver.23). The mean hypothalamic volume in the first year of life reached 69% of the mean hypothalamic volume between 0 and 18 years (1119.01 ± 196.09 mm 3 ), 88% in the second year. The mean volume of the hypothalamus without mammillary body increased in the five-age segment, while it increased in the six-age segment with mammillary body. Although the hypothalamus volumes of males were larger than females in all age groups, a significant difference was found between the age groups of 3-8 and 12-18 years (p < 0.05). In the pediatric brain, the hypothalamus was right-lateralized between 2.39% and 14.02%. The first 2 years of life were critical in the volumetric development of the hypothalamus. A segmental and logarithmic increase in the hypothalamus volume was demonstrated. In the pediatric brain, asymmetry and sexual dimorphism were detected in the hypothalamus. Information on normal hypothalamus structure and development facilitates the recognition of abnormal developmental trajectories., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Granulomatosis with polyangiitis is a systemic necrotizing granulomatous vasculitis that can predominantly affect systemic small- and medium-sized vessels. Isolated pituitary gland involvement at the onset of the disease is extremely rare in granulomatosis with polyangiitis and usually associated with other organ involvement, especially upper and lower respiratory tract and kidneys. This report highlights granulomatosis with polyangiitis -related pituitary dysfunction with clinical, radiological, and laboratory findings., Competing Interests: None

Aim: To examine whether there was an improvement in the displaced fracture line in the follow-up, in which Anterior odontoid screw fixation (AOSF) was performed without manipulation and to determine the "displacement angle range" in which AOSF was possible., Material and Methods: A total of 11 patients with the diagnosis of type II odontoid fracture who underwent AOSF without manipulation were analyzed retrospectively. A control group of 30 cases was formed and odontoid related angle measurements were performed on cervical computed tomographies (CT) of the control group and the patients who were operated., Results: In 6 of 7 cases in the posterior-displaced group along with all cases in the anterior-displaced group, it was determined that the displacement angles returned to the normal range in the 1st year follow-up. In 1 case having posterior displacement with posterior longitudinal ligament (PLL) damage, it was observed that the displacement angle improved to the normal range significantly, but the displacement continued., Conclusion: AOSF is a minimally invasive, safe and effective method in patients with displaced type II odontoid fracture, which is between the median odontoidobasal angle range of 100°-134°, whose PLL is preserved, and which cannot be manipulated.

Objective: To assess vascular opacifications, the efficiency, and interobserver agreement (IOA) of five different computed tomography angiography (CTA) brain death (BD) scoring systems in patients with and without cranial interventions, for determining alternative findings correctly supporting BD diagnosis by CTA even in cranial intervention presence., Methods: 45 patients clinically identified with BD and evaluated with CTA were included. IOA of five different scoring systems used for CTA BD diagnosis, the effect of intracranial interventions on scoring systems, and vascular opacification were evaluated., Results: IOA was almost perfect (κ = 0.843-0.911, p < 0.05) and substantial (κ = 0.771-0.776, p < 0.05) in all scoring systems. Significant relationships were observed between craniectomy presence and middle cerebral artery M4 segment and internal cerebral vein (ICV) opacification. No opacification was observed in straight sinus (SS) by observers in any of the craniectomized patients., Conclusion: IOA of CTA scoring systems is adequate. But a significant degree of false-negative results is observed due to ICV filling in craniectomy cases. Opacification presence in SS can give an idea of BD in these cases., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to evaluate the diagnostic performance of Inhance 3D Velocity (I3DV) in intracranial venous thrombosis and investigate the possible impact of venous sinus hypoplasia/aplasia on false thrombosis diagnosis made with I3DV., Methods: This study included 540 patients. Contrast-enhanced magnetic resonance venography combined with conventional sequences was considered the gold standard test (GST), while I3DV was considered as diagnostic test. We accessed the diagnostic success of I3DV for intracranial venous thrombosis detection, thrombosed vessel identification, and total/partial thrombus distinction. The possible relationship between false-positive thrombus diagnosed by I3DV and venous sinus hypoplasia or aplasia diagnosed by GST was investigated., Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of I3DV in the detection of intracranial venous thrombosis were 95.7%, 92.1%, 64.1%, 99.3%, and 92.6%, respectively. A significant association was observed between I3DV and GST in terms of thrombosis detection and total/partial thrombus distinction (p < 0.001). A significant relationship was observed between false-positive thrombosis diagnosis in I3DV and hypoplasia in the left transverse sinus (p < 0.001)., Conclusion: Intracranial venous thrombosis may be diagnosed faster and more accurately than traditional phase contrast magnetic resonance angiography in I3DV. This technique can be used in situations where contrast medium application is contraindicated. As in other non-contrast magnetic resonance venography techniques, left transverse sinus hypoplasia can be diagnosed as a thrombosed vessel in I3DV., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In this article, we present a case of leptomeningeal pneumocephalus and pneumorrhachis secondary to pneumothorax that occurred six years after syringopleural shunting., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: To investigate the shape differences in the putamen of early-onset Parkinson's patients compared with healthy controls and to assess and to assess sub-regional brain abnormalities., Methods: This study was conducted using the 3-T MRI scans of 23 early-onset Parkinson's patients and age and gender matched control subjects. Landmark coordinate data obtained and Procrustes analysis was used to compare mean shapes. The relationships between the centroid sizes of the left and right putamen, and the durations of disease examined using growth curve models., Results: While there was a significant difference between the right putamen shape of control and patient groups, there was not found a significant difference in terms of left putamen. Sub-regional analyses showed that for the right putamen, the most prominent deformations were localized in the middle-posterior putamen and minimal deformations were seen in the anterior putamen., Conclusion: Although they were not as pronounced as those in the right putamen, the deformations in the left putamen mimic the deformations in the right putamen which are found mainly in the middle-posterior putamen and at a lesser extend in the anterior putamen., (Copyright © 2021 Elsevier B.V. All rights reserved.)