1.Computed Tomography Perfusion Imaging on Traumatic Cerebral Contusion: A Preliminary Report
Ahmad Helmy Abdul Karim ; Win Mar @ Salmah Jalaluddin ; Ab Rahman Izaini Ghani
Malaysian Journal of Medical Sciences 2010;17(4):51-56
Background: Brain ischaemia and infarction are the leading factors in morbidity and
mortality of traumatic brain injury. This study aimed to determine the perfusion status of
pericontusional hypodense areas in traumatic cerebral contusion
Methods: Ten patients involved in motor vehicle accidents were enrolled in this study,
and contusions were diagnosed from plain computed tomography scans of the brain. Subsequent
computed tomography perfusion (CTP) was performed to analyse the perfusion of pericontusional
hypodense areas, which were divided into 4 regions of interest (ROI).
Results: Most ischaemic perfusion was found in ROI 6 (affecting 60% of patients), although
the mean of the perfusion parameters were normal. A significant positive correlation was found
between the perfusion status in the pericontusional area nearest to the skull vault (ROI 3) and its
distance/thickness to the skull vault (r = 0.698, P = 0.025). Two adjacent pericontusional hypodense
areas (ROI 4 and ROI 5) showed a significant positive correlation with each other (r = 0.667, P =
0.035) in terms of perfusion status. The presence of a hypodense pericontusional area is suggestive
of oedema and perfusion disturbances.
Conclusion: CTP is a useful, fast, and appropriate method in evaluating perfusion of
pericontusional hypodensity area that may help the treating physician to provide an appropriate
treatment to the patient.
2.MR Volumetry of Hippocampus in Normal Adult Malay of Age 50 Years Old and Above
Muhammad Fadli Embong ; Ruwaida Yaacob ; Mohd Shafie Abdullah ; Ahmad Helmy Abdul Karim ; Anis Kausar Ghazali ; Win Mar @ Salmah Jalaluddin
Malaysian Journal of Medical Sciences 2013;20(4):25-31
Background: Hippocampal volume is affected by several psychiatric illnesses of old age, as well as by normal aging. It is important to have a normal data in a population to assist in diagnosis. The aim of this study is to determine hippocampal volume in normal Malay people aged 50 years old and older.
Methods: This was a cross-sectional study of the normal Malay population aged 50 to 77 years. We included 43 participants, representing 19 men and 24 women. Magnetic resonance imaging (MRI) was performed using a GE Signa Horizon LX 1.0 Tesla. Oblique coronal images of temporal lobes were obtained and hippocampal volumetry was done manually and normalised with intracranial volume.
Results: Mean right and left hippocampal volumes (HCVs) were 3.43 cm3 (SD 0.32) and 3.26 cm3 (SD 0.34), with a significant difference between them (P < 0.001). Total mean HCVs exhibited no significant difference between men and women (P = 0.234). The means of the normalised right and left HCVs were 3.42 cm3 (SD 0.31) and 3.26 cm3 (SD 0.32).
Conclusion: The mean right and left hippocampal volumes were significantly different in this study. Men had slightly larger mean HCVs but the difference was not statistically significant. It was found that normalisation further reduces the mean volume difference between the genders.
Magnetic Resonance Imaging
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Hippocampus
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Adult
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Reference Values
3.A humongous intraorbital foreign body in a "possessed"patient
Lee Foo KOK ; Ismail Raihan SITI ; Hussein ADIL ; Ibrahim MOHTAR ; lsmail Che HASANAH ; Jalaluddin Mar@Salmah WIN
International Eye Science 2010;10(8):1474-1476
A 39 years old gentleman presented with red painful right eye.He had self-inflicted an injury to his right eye with a wooden stick and he saw a vision of an old man indicating him to do so.Clinically,the right eye was moderately proptosed,complete ophthalmoplegia and the periorbital skin was severely swollen.Imaging showed right orbital cellulitis with inferior ophthalmic vein thrombosis,bilateral cavernous sinus syndromeandimpending cavernous sinus thrombosis.No intraorbital or intraocular foreign body was reported.Despite aggressive intraven ous antimicrobials,the patient's condition was not improved.Exploration done under anesthesia exposed a huge wooden stick at the inferior fornix.Patient showed a remarkable recovery after the removal of the foreign body may occur in psychiatry patient that a possibility of selfinflicted injury.A detailhistory,examinationand appropriate investigations are mandatory to reveal the correlated clinical findings with imaging studies are the most helpful guide in managing intraorbital foreign body could potentially prevent further serious morbidity or
4.Normalised MRI Volumetry of the Hippocampus among Normal Malay Children and Adolescents
Win Mar @ Salmah Jalaluddin ; Norhasiza Mat Jusoh ; Izzat Abdulla Ali Basahai ; Mohd Shafie Abdullah ; Ahmad Helmy Abdul Karim ; Anis Kausar Gazali
Malaysian Journal of Medical Sciences 2013;20(1):31-38
Background: Magnetic resonance imaging (MRI) is a noninvasive method for determining brain morphology and volumetry. Hippocampal volume changes are observed in conjunction with several diseases. This study aimed to determine the normalised volume of the hippocampus in normal Malay children and adolescents.
Methods: This was a cross-sectional study performed from January 2009 to June 2010. Brain and temporal lobe MRI was performed for 81 healthy normal Malay individuals aged 7–18 years. Manual volumetry was performed. The hippocampal volumes were normalised with the total intracranial volume.
Results: The original right, left, and total hippocampal volumes (mean and standard deviation) were 3.05 (0.48) cm3, 2.89 (0.44) cm3, and 5.94 (0.90) cm3, respectively. Normalised hippocampal volumes for the right, left, and total volume were 3.05 (0.41) cm3, 2.89 (0.41) cm3, and 5.94 (0.79) cm3, respectively. Pearson’s correlation coefficient for the right and left hippocampal volumes with intracranial volume were 0.514 and 0.413, respectively (P < 0.001). Both the original and normalised hippocampal volumes of the right hippocampus were significantly larger than those of the left (P < 0.001).
Conclusion: This is a data set for the local Malay paediatric population. There was no significant difference between the actual and normalised values of hippocampal volume in our study.