[Pontine and extra-pontine myelinolysis. Early diagnostic and prognostic value of cerebral CT and MRI].
Retrospective examination of 44 patients with central pontine and/or extrapontine myelinolysis leads to the conclusion that in early diagnostics cerebral NMR is superior to cCT. T2-weighted images turned out to be the most sensitive parameter. Frequent contrast-medium enhancement early in the course up to 4 weeks after clinical manifestation in 7 patients underlines the pathogenetic idea of an initial transient blood-brain barrier. According to our results, central-pontine myelinolysis (CPM) proof by NMR can be expected after 1 week. During the clinical course, cCT and NMR findings showed no regression. Also no connection was noted between the size of the pontine lesion and the favorable clinical course in 72.2% of the patients, nor was there a correlation with the extent of the neurological symptoms at the crisis of the disease. Altogether, cCT and NMR are irrelevant for the prognosis of cerebral myelinolysis.
Menger
H
H
Neurologische Klinik, Universität Witten/Herdecke, Klinikum Wuppertal.
Mackowski
J
J
Jörg
J
J
Cramer
B M
BM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001812:Blood-Brain Barrier / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis* / Q000209:etiology; D011149:Pons / Q000473:pathology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed