Study on 54 cerebral stroke- induced hemiplegia, ≥40 year-old patients at the first time, treated by movement massage approach in Hue Traditional Medical Hospital from August 2002. The results: massage and movement method in rehabilitation of hemiplegia patients achieved good results: 78% could lift up the arm, 74% could lift up the leg, 29% recovered movement of the hand. The effectiveness of the method were similar to that of electro-acupuncture method (p<0.01)
Stroke ; Stroke/rehabilitation ; Encephalomalacia

Various anatomical defects have been described in the surviving twin who had a stillborn, macerated monozygotic co-twin with Disseminated Intravascular Coargulation. The etiology is thought to be placental transfer of emboli or thromboplastic material through placental vascular anastomoses. We experienced a case of monozygotic twin with deceased co-twin at 30 weeks of gestation and confirmed to have antenatal periventricular germinal matrix and intraventricular hemorrhage, multicystic periventricular leukomalacia and diffuse encephalomalacia by neurosonography on first day of life despite of no clinical evidence of brain damage. The pathologic findings of placenta revealed infarct with massive fibrin deposition. A brief review of related literature is presented.
Brain* ; Encephalomalacia ; Fibrin ; Hemorrhage ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Placenta ; Pregnancy ; Twins ; Twins, Monozygotic*

Multicystic encephalomalacia is the condition defined anatomically by the presence of multiple cavities in the great part of both cerebral hemispheres. The most common cause of the condition was regarded as the circulatory disturbance during the perinatal period. Also, neonatal asphyxia was the most important cause of the circulatory disturbance. But we experienced a case of multicystic encephalomalacia in a liveborn twin with a stillborn co-twin without perinatal asphyxia. It seems likely that intrauterine disseminated intravascular coagualation owing to fetofetal transfer of thromboplastic material from the dead fetus through vascular shunts in a monochorionic placenta without neonatal asphyxia constitute the main cause of the neurologic complication in our patient. So we report with a brief review and its related literatures.
Asphyxia ; Cerebrum ; Encephalomalacia* ; Fetus ; Humans ; Placenta ; Twins*

PURPOSE: To demonstrate MR findings of cerebral palsy(CP), correlation with clinical findings, and differences between the full-term and pre-term group. MATERIALS AND METHODS: Brain MRI of 94 patients with cerebral palsy(CP) were reviewed. The frequency of each MR finding, statistical correlation with clinical findings including type, severity and extent of CP, and differences between the full-term and pre-term group were analyzed. RESULTS: Abnormal MR findings were found in 83 patients (88%), and were as follows: diffuse brain atrophy (30%); periventricular leukomalacia (PVL) (28%); infarction (11%), basal ganglia abnormality (11%); delayed myelination (10%); nonspecific tissue loss or encephalomalacia (9%); and cortical dysplasia (7%). Hemiplegia was the most common condition among patients with infarction, and was found in 80% of this group; diplegia was found in 50% of cases with diffuse brain atrophy, while paraplegia was found in 36% of those with normal MR findings (p<.05). Mild symptoms were dominant in patients with normal MR findings (82%) and in those with infarctions (90%) (p<.05). PVL was the dominant finding in the pre-term group (65%) whereas findings in the full-term group varied; in this group, 38% of MR findings suggested prenatal insults. Possible causative factors were found in 66% of the full-term and 80% of the pre-term group. Perinatal factors were dominant in the pre-term group (81%), whereas prenatal and postnatal factors showed relatively higher frequencies in the full-term group (30% and 24%, respectively). CONCLUSION: Diffuse brain atrophy and PVL were the most common MR findings. The extent of CP the pre-term correlated well with MR findings. PVL and perinatal factors were dominant in the per-term group, whereas variable MR findings and relatively higher frequencies of pre- and postnatal factors were found in the full-term group.
Atrophy ; Basal Ganglia ; Brain ; Cerebral Palsy* ; Encephalomalacia ; Hemiplegia ; Humans ; Infant, Newborn ; Infarction ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Myelin Sheath ; Paraplegia

PURPOSE: Hypoxic-ischemic encephalopathy is a major neurologic problem and one of the most important perinatal causes of neurological morbidity. Evaluation of the presence, extent, and subsequent evolution of hypoxic-ischemic lesions may be very important. We studied the significance of imaging modality through the analysis of brain MRI findings of hypoxic-ischemic encephalopathy during neonatal period and comparison with findings of brain ultrasonography. METHODS: We analysed the forty-seven infants retrospectively who were diagnosed as hypoxic-ischemic encephalopathy and underwent brain MRI and ultrasonography from Jan. 1992 to May 1996. RESULTS: 1) The mean gestational age and birth weight of the twenty-seven infants who were premature were 32.8+/-2.08weeks and 1.97+/-0.44kg respectively. The mean gestational age and birth weight of twenty infants who were fullterm were 39.3+/-1.04weeks and 2.98+/- 0.93kg respectively. The primary hypoxic-ischemic insults occurred during antenatal, intrapartum and postnatal period. 2) The findings of brain MRI were classified into periventricular leukomalacia, encephalomalacia, basal ganglia lesion, focal parenchymal hemorrhage, ventriculomegaly without other lesion and normal finding. 3) Three infants among twenty-five infants with periventricular leukomalacia, four infants among seven infants with basal ganglia lesion and six infants among seven infants with focal parenchymal hemorrhage were not diagnosed by brain ultrasonography. 4) All of ten infants with encephalomalacia and four infants with ventriculomegaly without other lesion were diagnosed by brain ultrasonography. CONCLUSIONS: MRI can diagnose the hypoxic-ischemic lesions which would not be possible by brain ultrasonography. Therefore MRI is the imaging modality of choice for diagnosis in infants with hypoxic-ischemic encephalopathy. We believe that the benefits of MRI outweigh its somewhat higher cost, lack of portability and monitoring difficulties.
Basal Ganglia ; Birth Weight ; Brain ; Diagnosis ; Encephalomalacia ; Gestational Age ; Hemorrhage ; Humans ; Hypoxia-Ischemia, Brain* ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging* ; Retrospective Studies ; Ultrasonography

PURPOSE: Hypoxic-ischemic encephalopathy is a major neurologic problem and one of the most important perinatal causes of neurological morbidity. Evaluation of the presence, extent, and subsequent evolution of hypoxic-ischemic lesions may be very important. We studied the significance of imaging modality through the analysis of brain MRI findings of hypoxic-ischemic encephalopathy during neonatal period and comparison with findings of brain ultrasonography. METHODS: We analysed the forty-seven infants retrospectively who were diagnosed as hypoxic-ischemic encephalopathy and underwent brain MRI and ultrasonography from Jan. 1992 to May 1996. RESULTS: 1) The mean gestational age and birth weight of the twenty-seven infants who were premature were 32.8+/-2.08weeks and 1.97+/-0.44kg respectively. The mean gestational age and birth weight of twenty infants who were fullterm were 39.3+/-1.04weeks and 2.98+/- 0.93kg respectively. The primary hypoxic-ischemic insults occurred during antenatal, intrapartum and postnatal period. 2) The findings of brain MRI were classified into periventricular leukomalacia, encephalomalacia, basal ganglia lesion, focal parenchymal hemorrhage, ventriculomegaly without other lesion and normal finding. 3) Three infants among twenty-five infants with periventricular leukomalacia, four infants among seven infants with basal ganglia lesion and six infants among seven infants with focal parenchymal hemorrhage were not diagnosed by brain ultrasonography. 4) All of ten infants with encephalomalacia and four infants with ventriculomegaly without other lesion were diagnosed by brain ultrasonography. CONCLUSIONS: MRI can diagnose the hypoxic-ischemic lesions which would not be possible by brain ultrasonography. Therefore MRI is the imaging modality of choice for diagnosis in infants with hypoxic-ischemic encephalopathy. We believe that the benefits of MRI outweigh its somewhat higher cost, lack of portability and monitoring difficulties.
Basal Ganglia ; Birth Weight ; Brain ; Diagnosis ; Encephalomalacia ; Gestational Age ; Hemorrhage ; Humans ; Hypoxia-Ischemia, Brain* ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging* ; Retrospective Studies ; Ultrasonography

PURPOSE: It has been customary to perform brain ultrasonogram (brain US) for the early detection of intraventricular hemorrhage (IVH) during intensive care of neonates. On the other hand magnetic resonance imaging (MRI) has been greatly restrictioned due to its complicated procedures. This study was conducted to identify changes in neonates' brain structure and to gain basic data for the long-term follow-up of neurologic sequelae in the future. For this purpose, the findings obtained from both brain US performed within one postnatal week and MRI at the time of discharge were compared and analysed. METHODS: Brain US within one postnatal week and MRI at discharge were carried out on 67 neonates who were discharged from the neonatal intensive care unit of Fatima Hospital from July 01, 1996 to June 30, 1998. We compared and analysed IVH found in the brain US, and focal parenchymal hemorrhage, periventricular leukomalacia (PVL), basal ganglia hemorrhage, and encephalomalacia revealed the MRI performed at discharge. RESULTS: It was found that out of 67 cases from the brain US, there were 13 with IVH of Grade l & ll, 11 with IVH of Grade lll or higher, one with focal parenchymal hemorrhage, and three with PVL. Also the MRI found seven with focal parenchymal hemorrhage, one with basal ganglia hemorrhage, six with PVL, three with encephalomalacia, and one with ventricular dilatation. CONCLUSION: For infants with IVH of Grade lll or higher, MRI performed at discharge is considered to be very useful in identifying structural parenchymal abnormality and the presence or absence of its associated lesions as well as in carrying out long-term follow-up.
Basal Ganglia Hemorrhage ; Brain* ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Critical Care ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging* ; Ultrasonography*

PURPOSE: The aim of this study was to characterize the brain ultrasonographic findings of late-onset circulatory dysfunction (LCD) due to adrenal insufficiency (AI) in preterm infants. METHODS: Among the 257 preterm infants born at <33 weeks of gestation between December 2009 and February 2014 at our institution, 35 preterm infants were diagnosed with AI. Brain ultrasonographic findings were retrospectively analyzed before and after LCD in 14 preterm infants, after exclusion of the other 21 infants with AI due to the following causes: death (n=2), early AI (n=5), sepsis (n=1), and patent ductus arteriosus (n=13). RESULTS: Fourteen of 257 infants (5.4%) were diagnosed with LCD due to AI. The age at LCD was a median of 18.5 days (range, 9 to 32 days). The last ultrasonographic findings before LCD occurred showed grade 1 periventricular echogenicity (PVE) in all 14 patients and germinal matrix hemorrhage (GMH) with focal cystic change in one patient. Ultrasonographic findings after LCD demonstrated no significant change in grade 1 PVE and no new lesions in eight (57%), grade 1 PVE with newly appearing GMH in three (21%), and increased PVE in three (21%) infants. Five infants (36%) showed new development (n=4) or increased size (n=1) of GMH. Two of three infants (14%) with increased PVE developed cystic periventricular leukomalacia (PVL) and rapid progression to macrocystic encephalomalacia. CONCLUSION: LCD due to AI may be associated with the late development of GMH, increased PVE after LCD, and cystic PVL with rapid progression to macrocystic encephalomalacia.
Adrenal Insufficiency* ; Brain* ; Ductus Arteriosus, Patent ; Encephalomalacia ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Leukomalacia, Periventricular ; Pregnancy ; Retrospective Studies ; Sepsis ; Ultrasonography

PURPOSE: To evaluate the utility of fluid-attenuated inversion recovery(FLAIR) sequence by comparing thesignal intensities in various cerebral lesions with those on T2-weighted MR imaging. MATERIALS & METHODS: In 41patients who showed different signal intensities between T2-weighted images and FLAIR sequences, we reviewed theVirchow-Robin space(VRS), acute or chronic infarctions including lacunar cavities, and postoperativeencephalomalacia. In all patients, the location, shape and size of abnormal signal intensities were evaluated. RESULTS: The hyperintensities of VRS and lacunar infarctions on T2-weighted imaging appeared as hypointensitieson FLAIR imaging. The hyperintense rims or crescents around lacunar cavities were only detected on FLAIR imaging.The extent of acute and chronic infarctions with homogenous hyperintensities seen on T2-weighted images was welldelineated on FLAIR imaging. Postoperative encephalomalacia and adjacent lesions showed low and high signalintensities, respectively, on FLAIR imaging, though they were hyperintense on T2-weighted images. CONCLUSION: ForVRS, infarction and encephalomalacia, FLAIR provides images that are superior to T2-weighted images, and may thusbe useful as an additional MR sequence in various cerebral lesions.
Encephalomalacia ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Stroke, Lacunar

The magnetic resonance imaging findings of multicystic encephalomalacia are featured by bilateral frontal large cystic lesion with corpus callosum involvement,evident heterogeneous enhancement of the lesion margin,ring hyperintensity on diffusion weighted imaging,and high choline peak and low N-acetylaspartate peak of the enhanced lesion margin on magnetic resonance spectroscopy.This article reports a case of multicystic encephalomalacia.
Corpus Callosum ; Encephalomalacia ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy