Luiz Celso Hygino da Cruz

CDPI/DASA · Radiology

Paracoccidioidomycosis (PCM) is a infection caused by the thermodimorphic fungus Paracoccidioides spp. (P. lutzii and, mainly, P. brasiliensis). This infection predominantly affects rural male workers aged between 30 and 50 years old who deal with soil on daily activities. Clinically, the disease is classified as acute/subacute phase, which evolves...

Metabolic and toxic myelopathies usually occurs due to several different causes. Metabolic myelopathy usually occurs due to deficiency of a nutrient, such as vitamin B12. Toxic myelopathy occurs secondary to the exposure to an external toxic agent. Although they may have a difficult diagnosis, determination of the specific cause of myelopathy is of...

Vasculitis is a complication of several infectious diseases affecting the central nervous system, which may result in ischemic and/or hemorrhagic stroke, transient ischemic attack, and aneurysm formation. The infectious agent may directly infect the endothelium, causing vasculitis, or indirectly affect the vessel wall through an immunological mecha...

The vestibulocochlear nerve is the eighth cranial nerve, entering the brainstem in the medullopontine sulcus after crossing the internal auditory canal and cerebellopontine angle cistern. It is a purely sensitive nerve, originating from the Scarpa's and spiral ganglions, responsible for balance and hearing. It has 6 nuclei located in the lower pons...

Syphilis is an infectious disease caused by the spirochete Treponema pallidum, subspecies pallidum. Although its incidence has declined after the widespread availability of penicillin, it has recently re-emerged, especially in men who have sex with men and in people living with human immunodeficiency virus (HIV). The neurological manifestations of...

Tuberous sclerosis complex (TSC) is a multiple system neurocutaneous syndrome with a genetic disorder caused by different mutations in TSC1 or TSC2. Usually, TSC causes tumors in the heart, brain, kidneys, eyes, and lungs. However, tumors can also develop in any other organs. The prenatal diagnosis of TCS is based on the identification of fetal car...

Brain death is the irreversible cessation of all brain function. Although protocols for its determination vary among countries, the concept of brain death is widely accepted, despite ethical and religious issues. The pathophysiology of brain death is related to hypoxia and ischemia in the setting of extensive brain injury. It is also related to the...

The hypoglossal nerve is the twelfth cranial nerve, exiting the brainstem in the preolivary sulcus, passing through the premedullary cistern, and exiting the skull through the hypoglossal canal. This is a purely motor nerve, responsible for the innervation of all the intrinsic tongue muscles (superior longitudinal muscle, inferior longitudinal musc...

The hypoglossal nerve is the twelfth cranial nerve, exiting the brainstem in the preolivary sulcus, passing through the premedullary cistern, and exiting the skull through the hypoglossal canal. This is a purely motor nerve, responsible for the innervation of all the intrinsic tongue muscles (superior longitudinal muscle, inferior longitudinal musc...

Background How the prefrontal cortex (PFC) recovers its functionality following lesions remains a conundrum. Recent work has uncovered the importance of transient low-frequency oscillatory activity (LFO; < 4 Hz) for the recovery of an injured brain. We aimed to determine whether persistent cortical oscillatory dynamics contribute to brain capabilit...

Sjögren's syndrome can be complicated by several neurological manifestations, including aseptic meningitis, which can be manifested with headache, flu-like symptoms, confusion, fever, signs of meningeal irritation, with or without focal neurological symptoms and cranial nerve palsy. Neuroimaging can reveal contrast enhancement in the lepto- or pach...

Diffusion magnetic resonance imaging (MRI) provides image contrast dependent on the motion of water molecules. This chapter discusses the role of this MRI technique in the diagnostic and post-treatment evaluation of brain tumours. The physical basis of diffusion-weighted imaging and diffusion tensor imaging (DTI) and the clinical application of the...

The trigeminal nerve is the fifth cranial nerve and is a sensory-motor nerve that provides the innervation to the face with its three roots. The trigeminal nerve can be affected by several diseases, such as vascular conflict, congenital malformation, inflammatory or neoplastic diseases. Magnetic Resonance Imaging (MRI) plays a crucial role in its e...

The oculomotor nerve is the third cranial nerve, exiting the brainstem in the medial border of the cerebral peduncle, from where it crosses straight to the superior orbital fissure. It is a purely motor nerve responsible for the innervation of all the extraocular muscles, except the superior oblique and lateral rectus muscles. It also has parasympa...

Arboviruses are zoonotic RNA viruses maintained in nature in cycles that involve arthropod vectors. The arboviruses that cause disease in humans are members of the Bunyaviridae, Togaviridae, Flaviviridae, and Reoviridae families. These viral species have geographically and climatically restricted distributions due to particular ecological and vecto...

Although vaccination against Coronavirus disease-2019 (COVID-19) is still occurring, several adverse effects temporally related to these vaccines are already being reported, even if through isolated case reports. In the present study, we describe the lesions seen on magnetic resonance imaging (MRI) of three patients who developed neurological sympt...

Chikungunya fever is an arbovirus infection transmitted by the same mosquito vector of dengue and Zika virus. Besides high fever, common clinical symptoms include articular pain and general malaise. Neurological involvement is unusual, but some patients may develop peripheral and central nervous system involvement, including meningoencephalitis, my...

The complete features of the neurological complications of coronavirus disease 2019 (COVID-19) still need to be elucidated, including associated cranial nerve involvement. In the present study we describe cranial nerve lesions seen in magnetic resonance imaging (MRI) of six cases of confirmed COVID-19, involving the olfactory bulb, optic nerve, abd...

The term congenital Zika syndrome (CZS) describes the spectrum of fetal and/or newborn findings associated with maternal-fetal Zika virus (ZIKV) transmission. Since 2015, congenital ZIKV infection is linked to microcephaly. Although microcephaly is the hallmark of CZS, not all affected fetuses have microcephaly. There is a wide range of other signs...

Zika virus (ZIKV) infection is associated with a number of neurological complications, in adults and older children, such as Guillain-Barré syndrome, encephalitis/meningoencephalitis, myelitis, and acute disseminated encephalomyelitis (ADEM). ADEM is an immune-mediated inflammatory demyelinating disorder of the central nervous system (CNS), predomi...

Severe neurologic complications are associated with Zika virus (ZIKV) infection. Congenital Zika syndrome (CZS) results from vertical transmission of ZIKV from an infected woman to the fetus during pregnancy. The viral transmission occurs through the placenta. The neurological complications of CZS are caused by affection of the neural stem cells by...

FIGURE 1: The reactivation of varicella zoster virus is complicated by myelitis and radiculitis. Cervical spine MRI showing hyperintense signal in the left gray matter columns of the spinal cord at C3 to C5 based on axial T2-weighted imaging (arrow in A) and sagittal STIR (arrow in B), and with contrast enhancement (arrow in C). Contrast enhancemen...

Melanoma is a malignant neoplasm of melanin-producing cells. Melanoma usually occurs in the skin, but can also arise in any anatomical site that contains melanocytes, such as mucous membranes, the eyes, and the central nervous system (CNS). Primary CNS malignant melanoma most often develops in the leptomeninges. We report a case of a rare intramedu...

Intracranial vessel wall imaging plays an increasing role in diagnosing intracranial vascular diseases. With the growing demand and subsequent increased use of this technique in clinical practice, radiologists and neurologists should be aware of the choices in imaging parameters and how they affect image quality, clinical indications, methods of as...

Chikungunya virus can be transmitted perinatally leading to serious neurological sequelae. We report the longitudinal evolution of the brain magnetic resonance imaging aspects of three cases of mother-to-child Chikungunya virus transmission. The first magnetic resonance imaging scan presented brain cavitations, with or without corpus callosum diffu...

Neurologic complications are being recognized as important outcomes of coronavirus disease 2019 (COVID-19). Pathogenesis is varied and incompletely understood, and may include neuroinvasion, indirect post-infectious neuroinflammation, and cerebrovascular pathologies. We present a case of COVID-19-related encephalomyeloradiculitis with clinical and...

Neurologic complications are being recognized as important outcomes of coronavirus disease 2019 (COVID-19). Pathogenesis is varied and incompletely understood, and may include neuroinvasion, indirect post-infectious neuroinflammation, and cerebrovascular pathologies. We present a case of COVID-19-related encephalomyeloradiculitis with clinical and...

We read with great interest the article written by Long et al. and published in The Journal of Emergency Medicine entitled, “The Thunderclap Headache: Approach and Management in the Emergency Department” (1). The authors provided an excellent review of the various conditions that can present clinically in association with thunderclap headaches. The...

Since 2005, it has been known that mother-to-child transmission of the chikungunya virus is possible. Transmission generally occurs in the perinatal period. In the present study, we describe the brain lesions seen on MR imaging of 6 cases of perinatal chikungunya infection. Patients who underwent brain MR imaging in the acute phase presented with a...

Importance Congenital Zika virus (ZIKV) infection may present with a spectrum of clinical and neuroradiographic findings. Objective To determine whether neuroimaging findings for infants with a history of ZIKV exposure are associated with infant clinical outcomes and gestational age at antenatal ZIKV infection. Design, Setting, and Participants T...

Our purpose is to describe typical computed tomography and magnetic resonance imaging findings in encephalopathies in the emergency. The focus of this article are the most frequent toxic and acquired metabolic diseases and their preferential sites of involvement, such as hepatic encephalopathy, hypoglicemia, nonketotic hyperglycemia, osmotic demyel...

When the first suspected cases of neurologic disorders associated with the Zika virus were noticed in Brazil in late 2015, several studies had been conducted to understand the pathophysiology of the disease and its associated complications. In addition to its well-established association with microcephaly in neonates, the Zika virus infection has a...

Relatively few agents have been associated with congenital infections involving the brain. One such agent is the Zika virus, which has caused several outbreaks worldwide and has spread in the Americas since 2015. The Zika virus is an arbovirus transmitted by infected female mosquito vectors, such as the Aedes aegypti mosquito. This virus has been c...

Zika virus (ZIKV) is a mosquito-borne arbovirus from the Flaviviridae family, first discovered in 1947. There has been no report of severe complications caused by this virus in humans until recently. However, it is confirmed now that prenatally acquired ZIKV infection may cause severe congenital brain abnormalities in the infected fetuses. In addit...

This chapter discusses the role of diffusion magnetic resonance imaging in the diagnostic evaluation of brain tumors. The physical basis of diffusion, diffusion tensor imaging, and diffusion kurtosis imaging; the clinical role of these tools in diagnosis; and the use of diffusion tensor imaging in surgical planning are discussed. There is also disc...

Functional MR imaging methods make possible the quantification of dynamic physiologic processes that occur in the brain. Moreover, the use of these advanced imaging techniques in the setting of oncologic treatment of the brain is widely accepted and has found worldwide routine clinical use.

Vascular malformations involving the brain are uncommon lesions that are seen increasingly more often in clinical practice, primarily because of advances in cross-sectional brain imaging. They are typically divided into two main categories: arteriovenous malformations and vascular malformations without arteriovenous shunting, including cavernous he...

The current treatment of glioblastoma patients based on surgery, radiation, and chemotherapy has achieved modest improvement in progression-free survival. In this direction, personalized treatment is the next achievement for better patient management and increased overall survival. Genetic characterization of high-grade gliomas by MR imaging is the...

Perfusion is a fundamental biological function that refers to the delivery of oxygen and nutrient to tissue by means of blood flow. This chapter will review all the existing methodologies to evaluate perfusion information with magnetic resonance imaging. For contrast-based techniques, acquisition details will be carefully explained for better under...

Objective: The purpose of this article is to discuss classic applications in diffusion-weighted imaging (DWI) in demyelinating disease and progression of DWI in the near future. Conclusion: DWI is an advanced technique used in the follow-up of demyelinating disease patients, focusing on the diagnosis of a new lesion before contrast enhancement....

In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This two-volume book is a practical manual on the various imaging techniques capable of delivering functional information on cancer, includi...

In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This well-illustrated two-volume book is a practical manual on the various imaging techniques capable of delivering functional information o...

Brain tumors are among the main causes of cancer-related deaths worldwide. Some brain neoplasms, like glioblastoma multiforme, are still some of the most malignant and fatal tumors known. Despite recent improvements in treatment, the prognosis remains dismal and most patients die. For monitoring of brain tumors, it is crucial to identify changes re...

I read with great interest the review article by Hock et al[1][1] and agree with the authors that 1H-MR spectroscopy can be of great value in the assessment of a variety of spinal cord diseases. The difficulty in determining a specific diagnosis of these lesions is a challenge in their management.

PURPOSE/AIM Although multiple sclerosis (MS) is the most known and studied demyelinating disease, demyelinating processes involving the CNS are related to a wide range of etiologies, including primary and secondary disorders. This exhibit aims to illustrate the main secondary causes of demyelination processes, focusing in the MRI findings that help...

Diffusion tensor imaging (DTI) is a new technique that allows the mapping of mean water diffusion in fibrous tissues. It depends on a property, known as diffusion anisotropy, which is based in the fact that water molecules diffuse more easily in the direction aligned with internal structure and with difficulty as it moves perpendicular to the prefe...

Diffusion-weighted (DW) magnetic resonance (MR) imaging provides potentially unique information on the viability of brain tissue. It provides image contrast that is dependent on the molecular motion of water, which may be substantially altered by disease. The primary application of DW MR imaging has been in brain imaging, mainly because of its exqu...

A 7-year-old boy presents with bilateral moderate hearing loss evolving with progressive loss of vision, aggressiveness, gait and coordination disturbances, and history of partial left hemibody seizures. X-linked recessive adrenoleukodystrophy (ALD) is the most frequent peroxisomal disorder, affecting the white matter of the central nervous system...

PURPOSE/AIM Though brain neoplasm treatment has improved, the characteristics and the imaging findings related to treatment have changed. This exhibit aims to illustrate the most common MRI findings related to brain neoplasm treatment, with emphasis to MRI features that can help in the differential diagnosis between residual tumor and treatment rel...

Acquired white matter abnormalities in children may be due to a broad spectrum of disorders, with the most significant related to metabolic and toxic etiologies. Recognition of the imaging appearance of neonatal hypoglycemia, nonketotic hyperglycemia, hyperammonemia, hepatic encephalopathy, and central pontine myelinolysis (CPM) is essential becaus...

The current standard of care for newly diagnosed cases of high-grade glioma is surgical resection followed by RT with concurrent chemotherapy. The most widely used criteria for assessing treatment response are based on a 2D measurement of the enhancing area on MR imaging known as the Macdonald Criteria. Recently, nontumoral increases (pseudoprogres...

To compare the hippocampal volumes in patients with bipolar disorder (BD) and healthy controls, obtained by applying different segmentation methods (manual, Freesurfer [FS], and FSL). The study included 27 patients with BD and 40 healthy controls. T1-weighted images in the sagittal plane were acquired on a 3 Tesla (T) MR scanner. Hippocampal volume...

Diffusion-weighted imaging has been used extensively in clinical practice for the early diagnosis of central nervous system conditions that restrict the diffusion of water molecules because it provides information about tumor cellularity or abscesses containing viscous fluid. DTI can detect brain lesions before any conventional imaging. Even though...

For over 20 years, conventional MR imaging has been used for assessing brain tumors. However, conventional MR imaging tends to underestimate the extent of the tumor, perhaps leading to suboptimal treatment. New MR imaging tools have been widely used to determine the grade, heterogeneity, and extent of brain tumors. Diffusion-weighted imaging has be...

Multiple sclerosis (MS) is considered the most common inflammatory autoimmune neurologic disorder and the most frequent cause of nontraumatic neurologic disability in young and middle-age adults. This article reviews the basic features of its magnetic resonance (MR) imaging lesions and, primarily, the use of diffusion MR imaging, which is increasin...

Diffusion-weighted magnetic resonance imaging (DWI) provides image contrasts that are different from conventional magnetic resonance techniques. DWI is particularly sensitive for detecting acute ischemic stroke, but it also has many other clinical applications, including the evaluation of central nervous system (CNS) infections. This article addres...

PURPOSE/AIM - To introduce the current treatment options for high-grade gliomas - To discuss the pathophysiological and clinical features in cases of pseudoprogression - To illustrate the conventional and advanced MRI findings in these patients - To show the MRI findings that can help in the differential diagnosis between tumor recurrence and pseud...

To analyze the metabolic constitution of brain areas through proton magnetic resonance spectroscopy in children affected with fetal alcohol spectrum disorder compared with normal children. The sample of this case-control study included eight boys with epidemiologic history of in utero exposure to alcohol (median age 13.6+/-3.8 years) who were diagn...

To evaluate the fractional anisotropy (FA) values of the multiple sclerosis (MS) plaques and normal-appearing cervical spinal cord (NASC) by diffusion tensor MRI imaging (DTI). Forty-one patients with relapsing-remising MS and 37 controls were evaluated. All MRI exams were performed using a conventional protocol, as well as diffusion tensor MR imag...

To analyze and compare cerebral white matter tracts through diffusion tensor imaging in autistic and normal children. This is a case-control study on a sample of eight male, right-handed children diagnosed with autism according to Diagnostic and Statistical Manual of Mental Disorders-4th Edition criteria, and eight healthy age- and sex-matched cont...

Il vecchio detto che recita “un bambino non è un adulto piccolo” è perfetto per illustrare l’importanza della branca pediatrica nel campo radiologico. Come disse Lefèbvre (il padre della Società Europea di Radiologia Pediatrica, ESRP) nel 1958: “Poiché in pediatria perdere tempo comporta il rischio di perdere una vita o di procurare una disabilità...

PURPOSE To evaluate the fractional anisotropy (FA) values of the main fiber tracts of extremely preterm infants using diffusion tensor MR imaging (DTI). METHOD AND MATERIALS A cohort of 45 infants with gestational age of less than 30 weeks and median birth weight of 890g was studied. All the patients underwent MR imaging in a 1.5T scanner with sta...

PURPOSE To compare the susceptibility-weighted MR phase imaging (SWI) and T2*-weighted gradient-echo (GRE) imaging for detection of hemorrhage in patients with post-traumatic diffuse axonal injury. METHOD AND MATERIALS 15 patients (mean age 20 years) with diagnosis of post-traumatic diffuse axonal injury were studied. The MR imaging were performed...

PURPOSE To evaluate with diffusion tensor magnetic resonance (DT-MR) imaging the differences between acute and chronic demyelinating plaques in patients with multiple sclerosis (MS). METHOD AND MATERIALS 59 patients (43 females and 16 males; mean age 42 years) with relapsing-remising MS and 21 healthy volunteers, sex- and age- matched, were study...

PURPOSE METHOD AND MATERIALS RESULTS CONCLUSION CLINICAL RELEVANCE/APPLICATION The lumbar spine MRI with axial loading can be a good imaging alternative for the evaluation of symptomatic patients with degenerative disease.

PURPOSE To evaluate the diffusion tensor imaging (DTI) abnormalities in the white matter lesions of patients with human lymphotropic virus type I (HTLV I) associated myelopathy/tropical spastic paraparesis (HAM/TSP). METHOD AND MATERIALS We studied 11 cases of HAM/TSP, and an age- and gender-matched control group. All patients underwent brain MRI...

To evaluate the fractional anisotropy (FA) values of the normal-appearing white matter of the corpus callosum (CC) in patients with relapsing-remitting multiple sclerosis (MS). Fifty-seven patients with diagnosis of relapsing-remitting MS and 47 age- and gender-matched controls were studied. A conventional MR imaging protocol and a DTI sequence wer...