MRI and Mental disorders Seyed Kazem Malakouti, MD Faculty of Iran University of Medical Sciences...
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![Page 1: MRI and Mental disorders Seyed Kazem Malakouti, MD Faculty of Iran University of Medical Sciences Seyed Kazem Malakouti, MD.](https://reader035.fdocuments.us/reader035/viewer/2022070323/56649da65503460f94a91402/html5/thumbnails/1.jpg)
Seyed Kazem Malakouti, MD
MRI and Mental disorders
Seyed Kazem Malakouti, MDFaculty of
Iran University of Medical Sciences
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Seyed Kazem Malakouti, MD
• intra-axial : in brain or spinal cord tissue• astrocytoma and oligodendroglioma are intra-axial• brain tissue, ventricles
• extra-axial: extrinsic to brain • meningioma and Schwannoma • Epidural, subdural, subarachnoid
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Seyed Kazem Malakouti, MD
• Supra tentorial• Infra tentorial• Posterior fossa
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Seyed Kazem Malakouti, MD
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Seyed Kazem Malakouti, MD
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Seyed Kazem Malakouti, MD
Pituitary tumor
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Seyed Kazem Malakouti, MD
Pituitary tumor
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Seyed Kazem Malakouti, MD
• Virchow & robin space Perivascular space Penetration of subarachnoid into deep brain with capillaries• Small foci isointense to CSF
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Seyed Kazem Malakouti, MD
• Hypocampal region in AD
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Seyed Kazem Malakouti, MD
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Seyed Kazem Malakouti, MD
Normal pressure hydrocephalus
• Gait• Apraxia• Dementia• incontinence
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Seyed Kazem Malakouti, MD
Bilateral Pallidal necrosis
• CT scan & MRI slice• CO poisoning
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Seyed Kazem Malakouti, MD
Huntington disease
• 64 y.o male• Caudate atrophy• Pallidus atrophy
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Seyed Kazem Malakouti, MD
Normal hyperintensity of posterior limb of internal capsule
• 30 y.o• Intensity similar to
cortex in T2• Round, oval hyperinsity
area• Bilateral lesion• Ependemitis granularis,
normal view of hyperintesities : caps
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Seyed Kazem Malakouti, MD
Wilson disease
• Globus Pallidus hyperintensity
• Brain stem hyperintensity
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Seyed Kazem Malakouti, MD
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Seyed Kazem Malakouti, MD
• 36-year-old woman• dysarthria, • axial tremor• ataxia
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Seyed Kazem Malakouti, MD
WD– severe dysarthria– dysphonia, – akathisia, – truncal appendicular – tremor, – left hemiparesis– dystonia.
• Serum ceruloplasmin was markedly decreased at 10 mg/dL (normal 18 to 55 mg/dL)
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Seyed Kazem Malakouti, MD
WD
• “face of the giant panda” sign that is characteristic of Wilson’s disease
• T2-weighted axial MRI demonstrates the “face of the giant panda” in the midbrain with high signal in tegmentum and normal red nuclei (arrow)
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Seyed Kazem Malakouti, MD
• T2-weighted axial MRI reveals the
“face of the miniature panda” in pons with hypointensity of central tegmental tracts (arrow) with hyperintensity of aqueductal opening to fourth ventricle
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Seyed Kazem Malakouti, MD
• acoustic schwannoma: ~80% of CPA masses (most common by far)
• meningioma: ~10% of CPA masses (second most common)
• trigeminal schwannoma• facial nerve
schwannoma• ependymoma• metastasis
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Seyed Kazem Malakouti, MD
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Seyed Kazem Malakouti, MD
• Tegmentum – Periaqueductal gray (PAG) – The periaqueductal gray is the gray matter around the cerebral aqueduct that deals with pain.
• Substantia nigra and red nucleus – There are important components of the sensorimotor system, and play a role in Parkinson’s and dopamine.
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Seyed Kazem Malakouti, MD
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Seyed Kazem Malakouti, MD
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Seyed Kazem Malakouti, MD
• Tectum – The tectum is the dorsal surface of the midbrain. It is responsible for auditory/visual reflexes, like jumping when someone slams a door.
• Tectum includes:– Superior colliculi – The top part, which controls the
visual reflexes
– Interior colliculi - The bottom part, which control the auditory reflexes
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Seyed Kazem Malakouti, MD
Werniche encephalopathy
• 33 y.o• Tectum: white arrow, periaquedutal parnchma• Mamillary bodies: white
arrowheads
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Seyed Kazem Malakouti, MD
Werniche encephalopaty
• 53 yo• Hyperintensity of
mamillary bodies
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Seyed Kazem Malakouti, MD
• FLAIR sequence MRI image at the level of the midbrain increased signal in the periaqueductal gray matter
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Seyed Kazem Malakouti, MD
• Axial FLAIR images show abnormal high signal intensity in the mammillary bodies (white arrows)