The purpose of this study was to evaluate the correlation between magnetic resonance imaging (MRI) findings and demographic and clinical characteristics, response to treatment times, and recurrence rates of Sydenham's chorea (SC), the most common of the acquired pediatric choreas. The clinical and radiological findings of 12 patients presenting to the pediatric neurology clinic in the previous 4 years and diagnosed with SC on the basis of the modified Jones criteria were investigated retrospectively from the hospital files. In addition, we measured the maximum prefrontal cortex and basal ganglia (globus pallidus, putamen, and caudate nucleus) thicknesses in the axial plane from patients' cerebral MRIs and compared these values with prefrontal cortex and basal ganglia thicknesses of a healthy control group measured using the same technique. Patient and control groups' cranial and basal ganglia MRIs were found to be normal. However, patients' globus pallidus thicknesses were significantly lower than those of the healthy control group. Additionally, the globus pallidus values of patients with recurrent SC and a prolonged healing time were lower than average. However, we determined no significant difference in terms of prefrontal motor cortex, caudate nucleus, or putamen thicknesses between the patient and control groups. Low globus pallidus thicknesses in patients with SC may indicate atrophy associated with globus pallidus involvement. Further experimental and prospective and long-term studies are needed for a better understanding of the factors affecting the pathophysiology, recurrence, and healing time of SC.
Background: The purpose of study was to evaluate normal morphometric measurements of piriform aperture (PA) by limiting the age range in genders to show the morphometry of the relevant and close proximal cranial structures; and also to investigate whether these are in compliance with the golden ratio. Materials and methods: Our study was performed on 83 (42 female, 41 male) multidetector computed tomography images obtained from patients. A total of 14 morphological measurements were performed including the height of PA, the width of PA and 12 cranial structures; and these measurements were evaluated for compliance with the golden ratio. The differences of 14 parameters between the genders and age groups, and also the interaction of these two factors were analysed. Results: In our morphometric study, significant difference between the genders was found in all measurements except for the distance between vertex and rhinion (V~Rh), between rhinion and right foramen supraorbitalis (Rh~FSO R), between rhinion and left FSO (Rh~FSO L), and the width of PA on the level between the right and left foramen infraorbitalis (PAW~FIO) with the difference valid for both age subgroups (p < 0.05). When the differences between the age subgroups were evaluated, there was significant difference only at the widest distance of cranium (CW; p = 0.008); and it was observed that the average has increased with age in both genders. When the golden ratio was examined, the ratio of the distance between anterior nasal spine and nasion to the height of piriform aperture (NSA~N:PAH) was found to be within the limits of the golden ratio in males (p = 0.074). No golden ratio has been found in females. Conclusions: In our study, significant differences were detected between genders in all parameters of PA and in some parameters of the close cranial structures in the age group we examined. The effect of age was detected only in the CW parameter, and the PA and close cranial structures were not affected. In our study, the averages of the morphometric measurements of 13 parameters of young adults were determined. The PA and surrounding cranial structures are important for the area and related surgical procedures; however, gender differences must be considered in this respect. In addition to this, in the PA, which is the anterior limit of the skeletal nose in males, the NSA~N:PAH ratio having the ideal golden ratio limits is valuable in aesthetical terms and due to its position of the PA in the face.
Aim: The aims of our study were to refer to the complex relationship between idiopathic intracranial hypertension (IIHT) and cerebral sinovenous thrombosis (CSVT), and to determine the differences and commonalities between the patients with and without CSVT in their etiology, along with documenting the uncertainties in concluding on the diagnosis and treatment of these patients. Material and Methods: IIHT was diagnosed according to Dandy criteria, while CSVT was screened for by way of a cranial magnetic resonance imaging for all patients and cranial magnetic resonance venography only if the magnetic resonance imaging was nebulous or there was a family history. Results: We retrospectively evaluated a total of 26 patients (9 of whom had CSVT) diagnosed with IIHT between 2014 and 2018. A total of 9 patients with concurrent CSVT were described as suffering from vascular IIHT, while the remaining 17 were described as suffering from other IIHT. Demographic characteristics were similar in both groups (mean age: 12 vs. 11; male/female ratio: 2/7 vs. 5/12 in vascular IIHT and other IIHT, respectively). Clinical findings, cerebrospinal fluid-opening pressure values, and pathologies of etiology were also similar (vitamin D deficiency: 66% vs. 52%; vitamin B12 deficiency: 11% vs. none; iron deficiency: 22% vs. 11%; obesity: 22% vs. 23%). A mixture of acetazolamide, topiramate, anticoagulant therapy, and acetylsalicylic acid were given according to the diagnoses. Conclusion: CSVT is a common clinical entity among the causes of IIHT, and it should be taken into consideration in this patient group. However, there is a need for a common guideline for laboratory and imaging methods to understand the etiopathogenesis of childhood IIHT and determine the patients at risk.
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