Foci of MRI signal (pseudo lesions) anterior to the frontal horns: histologic correlations of a normal finding

Sze, Gordon; Armond, S. J. De; Brant‐Zawadzki, Michael; Davis, R.; Norman, David; Newton, Thomas H.

doi:10.2214/ajr.147.2.331

Cited by 119 publications

(65 citation statements)

References 13 publications

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“…Periventricular caps reflect predominantly a specific anatomic situation characterized by loosely arranged fine-fiber tracts with low myelin and high extracellular fluid content. In these lesions, ependymitis granularis which represents patchy loss of the ependyma with astrocytic gliosis is also frequently observed (42). A smooth periventricular halo has been linked to disruption of the ependymal lining with subependymal gliosis and concomitant loss of myelin.…”

Section: Histopathologic Correlatesmentioning

confidence: 99%

Classification of White Matter Lesions on Magnetic Resonance Imaging in Elderly Persons

Kim

MacFall

Payne

2008

Biological Psychiatry

433

415

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White matter lesions, commonly seen on magnetic resonance images of elderly people, are related to various geriatric disorders including cerebrovascular diseases, cardiovascular diseases, dementia, and psychiatric disorders. Currently, white matter lesions are divided into periventricular white matter lesions and deep white matter lesions. Although the meaning of these terms vary by study and this dichotomization itself is still in debate, a possible dissimilarity in pathogenic mechanisms between periventricular white matter lesions and deep white matter lesions are providing some clues for understanding pathophysiology of many geriatric syndromes associated with white matter lesions.We have reviewed the distinctions between periventricular white matter lesions and deep white matter lesions in terms of etiology, histopathology, functional correlates, and imaging methodologies. We suggest a new sub-classification of white matter lesions which may have better etiological and functional relevance than the current simple dichotomization. The new categories are juxtaventricular, periventricular, deep white, and juxtacortical. This new classification scheme may contribute to reducing the heterogeneity of white matter lesion findings in future research.

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Section: Histopathologic Correlatesmentioning

confidence: 99%

Classification of White Matter Lesions on Magnetic Resonance Imaging in Elderly Persons

Kim

MacFall

Payne

2008

Biological Psychiatry

433

415

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“…3a, b), and are considered to represent normal anatomical structures in the fasciculus subcallosus. Some authors suggest increased periventricular water content, which converges from the surrounding white matter in this area or comes from the intense venous network of this region [21,83]. Disruption of the ependymal lining of the lateral ventricle and subependymal gliosis, so-called ependymitis granularis, is another histologic finding almost invariably noted with periventricular smooth caps.…”

Section: Periventricular Wmcmentioning

confidence: 99%

“…Disruption of the ependymal lining of the lateral ventricle and subependymal gliosis, so-called ependymitis granularis, is another histologic finding almost invariably noted with periventricular smooth caps. It is not yet clear, if the ependymal alterations truly represent a pathologic phenomenon and contribute to the occurrence of periventricular changes [44,83]. A significant correlation between denudation of the ventricular lining and the extent of periventricular hyperintensities is in favor of such a mechanism [64].…”

Section: Periventricular Wmcmentioning

confidence: 99%

Heterogeneity in age-related white matter changes

et al. 2011

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White matter changes occur endemically in routine magnetic resonance imaging (MRI) scans of elderly persons. MRI appearance and histopathological correlates of white matter changes are heterogeneous. Smooth periventricular hyperintensities, including caps around the ventricular horns, periventricular lining and halos are likely to be of non-vascular origin. They relate to a disruption of the ependymal lining with subependymal widening of the extracellular space and have to be differentiated from subcortical and deep white matter abnormalities. For the latter a distinction needs to be made between punctate, early confluent and confluent types. Although punctate white matter lesions often represent widened perivascular spaces without substantial ischemic tissue damage, early confluent and confluent lesions correspond to incomplete ischemic destruction. Punctate abnormalities on MRI show a low tendency for progression, while early confluent and confluent changes progress rapidly. The causative and modifying pathways involved in the occurrence of sporadic age-related white matter changes are still incompletely understood, but recent microarray and genome-wide association approaches increased the notion of pathways that might be considered as targets for therapeutic intervention. The majority of differentially regulated transcripts in white matter lesions encode genes associated with immune function, cell cycle, proteolysis, and ion transport. Genome-wide association studies identified six SNPs mapping to a locus on chromosome 17q25 to be related to white matter lesion load in the general population. We also report first and preliminary data that demonstrate apolipoprotein E (ApoE) immunoreactivity in white matter lesions and support epidemiological findings indicating that ApoE is another factor possibly related to white matter lesion occurrence. Further insights come from modern MRI techniques, such as diffusion tensor and magnetization transfer imaging, as they provide tools for the characterization of

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“…First, the location and extent of white matter lesions by spin-echo pulsing were graded; small triangular foci surrounding the frontal horns were ignored because such foci have been reported to have no pathologic significance by histologic observation. 33 Grade 0 was defined as no white matter lesions except for small triangular foci surrounding the frontal horns; Grade 1 as thin bands surrounding the subependymal region of the ventricles; Grade 2 as thicker bands surrounding the subependymal region of the ventricles, with additional discrete patchy subcortical white matter lesions beside or above the lateral ventricles; Grade 3 as more extensive, confluent subcortical white matter lesions beside and above the lateral ventricles, partially confluent with the bands surrounding the lateral ventricles; and Grade 4 as marked thick, irregular bands completely surrounding the lateral ventricles ( Figure 1). The radiologist then graded the degree of atrophy of the corpus callosum by inversion-recovery pulsing as Grade 1, normal or only mild atrophy; Grade 2, moderate atrophy; and Grade 3, severe atrophy ( Figure 2).…”

Section: Methodsmentioning

confidence: 99%

A radiologic study of dynamic processes in lacunar dementia.

Tanaka

Mizuno

et al. 1989

Stroke

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Using magnetic resonance imaging and digitized brain computed tomography, we evaluated 33 elderly patients with documented lacunar stroke and divided them into three groups (nondemented, « = 15; borderline, ra=9; and demented, n=9) by neuropsychological assessments and DSM III criteria. We evaluated the extent of white matter lesions and the degree of atrophy of specific anatomic structures, such as the corpus callosum, using magnetic resonance imaging and quantified the volumes of the ventricles, the subarachnoid spaces, and the brain parenchyma using digitized brain computed tomography. Our results show that both borderline and demented patients had significantly more extensive white matter lesions than nondemented patients, indicating a significant relation between the extent of white matter lesions and intellectual decline. In addition, borderline and demented patients had significantly larger ventricles and more brain atrophy than nondemented patients; demented patients also had significantly larger subarachnoid spaces than nondemented patients and more brain atrophy than borderline patients. Our findings suggest that in most patients with lacunar stroke, periventricular and subcortical white matter lesions with subsequent white matter atrophy first induce ventricular enlargement, followed by generalized brain atrophy, resulting in dementia. (Stroke 1989;20:1488-1493 V ascular dementia and dementia of the Alzheimer type are two main types of dementia. Vascular dementia can be divided into three major subgroups: multiple discrete strokes following thrombotic or embolic occlusion of large cerebral arteries (multi-infarct dementia) 1 -2

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Foci of MRI signal (pseudo lesions) anterior to the frontal horns: histologic correlations of a normal finding

Cited by 119 publications

References 13 publications

Classification of White Matter Lesions on Magnetic Resonance Imaging in Elderly Persons

Classification of White Matter Lesions on Magnetic Resonance Imaging in Elderly Persons

Heterogeneity in age-related white matter changes

A radiologic study of dynamic processes in lacunar dementia.

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