BACKGROUND: Intracranial lipomas are uncommon benign lesions of the central nervous system. They preferentially occur near the midline, most frequently in the pericallosal cistern, and are often associated with various neurologic and systemic anomalies. Since the advent of CT scanning and MR imaging, unexpected findings of intracralial lipomas have increased. We identified 11 cases of intracranial lipomas diagnosed by CT and MR and analyzed their characteristic clinical and radiologic findings. METHODS: We retrospectively reviewed 11 cases of intracranial lipomas. MR was used in all cases and CT in three. RESULTS: There were seven men and four women whose ages ranged from six months to 76 years, with a mean of 39 years. Six (55%) lipomas were located in the quadrigeminal plate and five (45%) in the pericallosal area. The pericallosal lipomas were divided into three cases of curvilinear type and two cases of tubulonodular type. Of the six quadrigeminal lipomas, five cases (83%) were associated with either hypoplasia of the unilateral (four) or bilateral (one) superior and/or inferior colliculus. One case of quadrigeminal lipoma was associated with hypoplasia of the cerebellar vermis, agenesis of the septum pellucidum, and glioblastoma multiforme. All cases of pericallosal tubulonodular type were associated with dysgenesis of the corpus callosum and enlarged ventricles. However, all cases of pericallosal curvilinear type were not associated with other anomalies. Four (36%) cases found incidentally were asymptomatic. Seizure was the most frequent clinical presentation in five (45%) cases, followed by headaches in three (27%) and mental retardation in one (9%). Of five seizures cases, three had secondary generalized seizures and two had generalized tonic clonic seizures. CONCLUSIONS: Quadrigeminal and pericallosal lipomas were the most common types of intracranial lipomas. Sixty-three percent of the lesions were associated with adjacent brain malformations of varying degrees. Four cases were asymptomatic, while the others presented with seizures, headache, and mental retardation. (J Korean Neurol Assoc 19(2):149~154, 2001)
Brain ; Brain Neoplasms ; Central Nervous System ; Corpus Callosum ; Female ; Glioblastoma ; Headache ; Humans ; Inferior Colliculi ; Intellectual Disability ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Seizures ; Septum Pellucidum ; Tectum Mesencephali ; Tomography, X-Ray Computed

BACKGROUND: Intracranial lipomas are uncommon benign lesions of the central nervous system. They preferentially occur near the midline, most frequently in the pericallosal cistern, and are often associated with various neurologic and systemic anomalies. Since the advent of CT scanning and MR imaging, unexpected findings of intracralial lipomas have increased. We identified 11 cases of intracranial lipomas diagnosed by CT and MR and analyzed their characteristic clinical and radiologic findings. METHODS: We retrospectively reviewed 11 cases of intracranial lipomas. MR was used in all cases and CT in three. RESULTS: There were seven men and four women whose ages ranged from six months to 76 years, with a mean of 39 years. Six (55%) lipomas were located in the quadrigeminal plate and five (45%) in the pericallosal area. The pericallosal lipomas were divided into three cases of curvilinear type and two cases of tubulonodular type. Of the six quadrigeminal lipomas, five cases (83%) were associated with either hypoplasia of the unilateral (four) or bilateral (one) superior and/or inferior colliculus. One case of quadrigeminal lipoma was associated with hypoplasia of the cerebellar vermis, agenesis of the septum pellucidum, and glioblastoma multiforme. All cases of pericallosal tubulonodular type were associated with dysgenesis of the corpus callosum and enlarged ventricles. However, all cases of pericallosal curvilinear type were not associated with other anomalies. Four (36%) cases found incidentally were asymptomatic. Seizure was the most frequent clinical presentation in five (45%) cases, followed by headaches in three (27%) and mental retardation in one (9%). Of five seizures cases, three had secondary generalized seizures and two had generalized tonic clonic seizures. CONCLUSIONS: Quadrigeminal and pericallosal lipomas were the most common types of intracranial lipomas. Sixty-three percent of the lesions were associated with adjacent brain malformations of varying degrees. Four cases were asymptomatic, while the others presented with seizures, headache, and mental retardation. (J Korean Neurol Assoc 19(2):149~154, 2001)
Brain ; Brain Neoplasms ; Central Nervous System ; Corpus Callosum ; Female ; Glioblastoma ; Headache ; Humans ; Inferior Colliculi ; Intellectual Disability ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Seizures ; Septum Pellucidum ; Tectum Mesencephali ; Tomography, X-Ray Computed

Computerized tomography has been proven to be of particular value in patients with head trauma. Neverthless, primary traumatic brainstem lesions are not always revealing even by the advent of brain CT. In two cases of head trauma, we identified midbrain hemorrhage by CT scan. One of them was hemorrhage in the quadrigeminal plate, the quadrigeminal cistern, and the vermis; the other small round isolated hemorrhage in the quadrigeminal plate. They were well correlated with the clinical findings. Those two patients got well with conservative treatment.
Brain ; Brain Stem* ; Craniocerebral Trauma ; Hemorrhage ; Humans ; Mesencephalon ; Tectum Mesencephali ; Tomography, X-Ray Computed

With advances in MR imaging, reports of pineal cyst have become more common. In contrast to pineal neoplasm, a pineal cyst is usually asymptomatic and is detected incidentally. We reviewed six cases of pineal cyst diagnosed between 1991 and 1996. Only one patient presented with syncopal attack due to compression of the midbrain. MRI typically reveals a cystic mass with a mean diameter of 1.66cm and shows faint rim-like contrast enhancement. Since it shows the anatomic relationship of the cyst to the aquedect, sagittal MRI is the most useful diagnost test. In the one symptomatic patient, we performed suboccipital cramiectomy and removed the cyst. It contained clear fluid and was easily removed. Surgery can be considered only when the lesion produces symptoms due to compression of the quadrigeminal plate, aqueduct, or midbrain. The long term behavior of these lesions is, however, unknown, so only with follow-up for long time will appropriate management techniques become apparent.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Pineal Gland* ; Pinealoma ; Tectum Mesencephali

A 25 year old female patient with hyperemesis gravidarum developed mental confusion, gait disturbance and diplopia. MRI of this patient showed high-signal lesions in thalamus, floor of the fourth ventricle, periaqueductal gray matter, mammillary body, and corpora quadrigemina, The high signal areas correlated well with the anatomical distribution of pathologic lesions in wernicke's encephalopathy previously described.
Adult ; Diplopia ; Female ; Fourth Ventricle ; Gait ; Humans ; Hyperemesis Gravidarum* ; Magnetic Resonance Imaging* ; Mamillary Bodies ; Periaqueductal Gray ; Pregnancy ; Tectum Mesencephali ; Thalamus ; Wernicke Encephalopathy*

Methyl bromide is presently used as a fumigant for insects in soil, grains or fruit in storage or transport. It is a neurotoxic agent and has been responsible a number of deaths or acute poisonings among occupationally exposed persons. We report 2 patients, who had worked fumigation warehouse, presented with seizures and altered mental state. The serum concentrations of bromide were elevated 32.9 and 42.5 mg/l, respectively. Brain MRI showed bilateral symmetric high signal intensities in the splenium of corpus callosum, the globus pallidus, the quadrigeminal plate, the periaqueductal gray matter, the red nucleus, the substantia nigra, the medial lemniscus, the pontine tegmentum, the dentate nucleus, and the medulla. There was no brain lesion in the other patient. Appropriate and supervised handling of the chemical and regular education to workers are important to avoid the risk of methyl bromide poisoning.
Brain ; Edible Grain ; Cerebellar Nuclei ; Corpus Callosum ; Education ; Fruit ; Fumigation ; Globus Pallidus ; Humans ; Insects ; Magnetic Resonance Imaging ; Occupations ; Periaqueductal Gray ; Poisoning ; Red Nucleus ; Seizures* ; Soil ; Substantia Nigra ; Tectum Mesencephali

In order to present the optimal neuroscience tutorial material for medical students and researchers, this study is aimed to make neuro-digital slide and neuro-atlas based on the histological specimens of human spinal cord and brain stem. Cadavers which had agreed for organ donation for research purpose were used in this study. Brains and spinal cords were extracted within 24 hours after death, and then fixed with 10% neutral buffered formalin. Paraffin blocks were made with the following regions; 8 regions from the spinal cord (the levels of the upper cervical segment, the cervical enlargement, the upper thoracic segment, the mid thoracic segment, the lower thoracic segment, the upper lumbar segment, the lumbar enlargement, the sacral segment), 14 regions from the brain stem (the levels of the spinomedullary junction, the pyramidal decussation, the medial lemniscus decussation, the obex, the mid-olivary medulla, the upper medulla, the pontomedullary junction, the lower pons, the mid pons, the upper pons, the isthmus rhombencephali, the inferior colliculus, the superior colliculus, the posterior commissure). Using virtual microscope software, we made digital neuro-slides which can be used anywhere and anytime regardless of equipment of microscope. To help understanding anatomy and functions of nervous tissue, we also made neuro-atlas based on the digital slide images. As results, the outline and detailed structures of nuclei and tracts are easily discriminated and also matched with marks and nomenclatures of neuro-atlas. Moreover, the cytoarchitecture of each nucleus and histological features can be well distinguished. We hope that this product would be used as a useful neuroscience tutorial material for the medical and paramedical school students, clinical trainees like interns and residents, and also neuroscience researchers.
Brain ; Brain Stem ; Formaldehyde ; Humans ; Inferior Colliculi ; Neurosciences ; Paraffin ; Pons ; Pyramidal Tracts ; Spinal Cord ; Students, Medical ; Superior Colliculi ; Tissue and Organ Procurement

Nitric oxide is synthesized by neurons containing the nitric oxide synthase (NOS), and the nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) is a selective histochemical marker for the brain. Although, many reports have been published describing in detail the distribution of NADPH-d and tyrosine hydroxylase (TH), little information is available on possible morphological changes of NADPH-d and TH containing neurons during aging of the brain stem. Therefore, in this study, we assessed the effects of aging on the somal area and staining intensity of NADPH-d-positive and TH-immunoreactive (TH-IR) neurons in rat brain stem. In previous studies, enzyme activities of nitric oxide synthase (NOS) and NADPH-d were shown to be in an almost perfect correlation in the brain. Therefore, we evaluated the change of NADPH-d-positive neurons using a microdensitometrical method as a way of measuring changes in NOS activity. By using a double-labelling technique, we have shown that these two enzymes are located in separate neurons in most brain stem nuclei. In the aged group, the size of NADPH-d-positive neurons was not significantly changed in most nuclei of the brain stem compared to the control group. Staining intensity of NADPH-d-positive neurons was significantly changed in periaqueductal gray, superior colliculus and inferior colliculus in the aged group. In the aged rats, the size of TH-IR neurons was significantly changed in locus ceruleus and lateral paragigantocellular nucleus. Staining intensity of TH-IR neurons was significantly decreased in principal trigeminal nucleus, locus ceruleus and lateral paragigantocellular nucleus of the aged group. These results demonstrate that the NADPH-d-positive and TH-IR neurons are differently influenced by aging than the control group in the brain stem of rats. Difference in the changes of NADPH-d-positive neurons in brain stem nuclei suggest that neuronal NOS is regulated by different mechanims in the regions of the brain stem during aging.
Aging* ; Animals ; Brain Stem* ; Brain* ; Inferior Colliculi ; Locus Coeruleus ; NAD ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase ; Periaqueductal Gray ; Rats* ; Superior Colliculi ; Trigeminal Nuclei ; Tyrosine 3-Monooxygenase ; Tyrosine*

Voltage dependent calcium channels (VDCCs) mediate Ca++ influx into cells and are responsible for regulation of a variety of physiological effects. The key functional property of VDCCs are attributed to the calcium-pore forming alpha1 subunit. In this study, distribution pattern of alpha1 subunit (alpha1D, alpha1B, alpha1A, alpha1E) mRNA of VDCCs in developing and adult rat brain was investigated by in situ hybridization histochemistry. In the adult rat brain, each alpha1 subunit mRNA displayed a specific and distinct distribution pattern. alpha1D was highly expressed in the olfactory bulb, dentate gyrus, pituitary gland, pineal gland, hypothalamus, superior colliculus and cerebellum. Relatively low level of alpha1B was expressed throughout the whole brain and strong expression of alpha1A was observed in CA3 area of Ammon's horn, medial geniculate body, inferior colliculus and cerebellum. High level of alpha1E was found in the olfactory bulb, hippocampus, dentate gyrus, medial habenular nucleus and cerebellum. Moreover, alpha1B, alpha1A and alpha1E were expressed only in the nervous system but alpha1D was expressed not only in the nervous system but also in other tissues including liver, heart, lung and skeletal muscle. Generally the expression of alpha1D, alpha1A, and alpha1E subunit was observed from E14 and thereafter the intensity of labeling was gradually increased to P14 and then decreased to the adult level. But the expression of alpha1B subunit was observed from E14 and gradually increased to E20 and P0 and then decresaed. From the differential expressions of VDCC alpha1 subunits in developing and adult rat brain, it is suggested that each type of VDCCs may play a distinct roles in neural and nonneural tissues, and the VDCCs may be related with development of nervous system.
Adult ; Animals ; Brain* ; Calcium Channels* ; Calcium* ; Cerebellum ; Dentate Gyrus ; Geniculate Bodies ; Habenula ; Heart ; Hippocampus ; Humans ; Hypothalamus ; In Situ Hybridization ; Inferior Colliculi ; Liver ; Lung ; Muscle, Skeletal ; Nervous System ; Olfactory Bulb ; Pineal Gland ; Pituitary Gland ; Rats* ; RNA, Messenger* ; Superior Colliculi

In natural acoustical environments, most biologically related sounds containing frequency-modulated (FM) components repeat over periods of time. They are often in rapid sequence rather than in temporal isolation. Few studies examined the neuronal response patterns evoked by FM stimuli at different presentation rates (PR). In the present investigation, by using normal electrophysiological technique, we specifically studied the temporal features of response of the inferior collicular (IC) neurons to FM sweeps with different modulation ranges (MR) in conditions of distinct PR in mouse. The results showed that most of the recorded neurons responded best to narrower MRs (narrow-pass, up-sweep: 60.00%, 54/90; down-sweep: 63.33%, 57/90), while a small fraction of neurons displayed other patterns such as band-pass (up-sweep, 16.67%, 15/90; down-sweep, 18.89%, 17/90), all-pass (up-sweep, 18.89%, 17/90; down-sweep, 13.33%, 12/90) and wide-pass (up-sweep, 4.44%, 4/90; down-sweep, 4.44%, 4/90). Both the discharge rate and duration of recorded neurons decreased but the latency lengthened with increase in PR, when different PRs from 0.5/s to 10/s of FM sound were used. The percentage of total directional selective neurons, up-directional selective neurons, and down-directional selective neurons changed with the variation of PR or MR. These results indicate that temporal features of mouse midbrain neurons responding to FM sweeps are co-shaped by the MR and PR. Possible mechanisms underlying may be related to spectral and temporal integration of the FM sound by the IC neurons.
Acoustic Stimulation ; Animals ; Inferior Colliculi ; cytology ; Mice ; Neurons ; physiology