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D'Amico, A., Russo, C., Ugga, L., Mazio, F., Capone, E., D'Arco, F., Mankad, K., Caranci, F., Marano, E., Brunetti, A.
Can pontine trigeminal T2-hyperintensity suggest herpetic etiology of trigeminal neuralgia?
(2016) Quantitative Imaging in Medicine and Surgery, 6 (5), pp. 490-495. 
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994884887&partnerID=40&md5=2fdd743482a13368be8211db3120995e

DOI: 10.21037/qims.2016.01.07
AFFILIATIONS: Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Naples, Italy; 
Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; 
Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
ABSTRACT: Background: Trigeminal neuralgia (TN) is usually classified into two different categories: idiopathic and secondary. We have investigated the frequency of brainstem pontine lesions in patients with idiopathic TN without multiple sclerosis (MS) or stroke, and their association with herpes zoster (HZ) infection. Methods: Brain magnetic resonance imaging (MRI) studies of 28 patients with TN were retrospectively reviewed. Results: We found seven patients with clinical suspicion of HZ infection and pontine T2 hyperintense lesions, associated with nerve atrophy in one case. Fifteen patients had a neurovascular conflict (NVC) without brainstem involvement, two of them associated with trigeminal atrophy, while four patients had only volumetric reduction of the nerve. In all patients MRI findings were ipsilateral to the side of TN. Conclusions: Pontine T2 hyperintensities could be considered as a MRI sign of TN in patients without NVCs. This "trigeminal pontine sign" (TPS) is frequently found in association with herpetic infections. © Quantitative Imaging in Medicine and Surgery. All rights reserved.
CORRESPONDENCE ADDRESS: D'Amico, A.; Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Italy; email: doctoralex@hotmail.it

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D'Arco, F., Ugga, L., Caranci, F., Riccio, M.P., Figliuolo, C., Mankad, K., D'Amico, A.
Isolated macrocerebellum: Description of six cases and literature review
(2016) Quantitative Imaging in Medicine and Surgery, 6 (5), pp. 496-503. 
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994845888&partnerID=40&md5=35ac344c9b639a7bb48fcc8b82974f91

DOI: 10.21037/qims.2016.06.10
AFFILIATIONS: Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; 
Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy; 
Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Psychiatry Division, Second University of Naples, Caserta, Italy; 
Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
ABSTRACT: Background: Macrocerebellum is a rare entity described as an isolated and abnormal increase of the cerebellum (CB) size without morphological or signal abnormalities. There have been only eleven patients with macrocerebellum reported in the literature so far. Methods: From December 2011 to March 2014, among 950 paediatric patients that underwent a magnetic resonance scan of the brain in our department, in six subjects an abnormal increase of the cerebellar volume was suspected. A volumetric analysis was performed in all patients on T1-weighted 3D imaging to confirm the diagnosis of macrocerebellum. The ratios between (I) volume of the CB and volume of the supratentorial structures (STB) and (II) volume of the CB and the sum of CB and STB (WB) were calculated in order to normalize the absolute values obtained and compared with the normal values present in literature. Results and Discussion: Quantitative analysis confirmed an increased cerebellar volume relatively to the STB volume ("t": 6.9518; P<0.001) and to the WB ("t": 7.1415; P<0.001) volume in comparison to the normal controls available in literature. Clinical characteristics and other neuroradiological findings of the patients are described. We also describe the differential features between isolated macrocerebellum and other pathological conditions that are characterized by cerebellar enlargement such as Lhermitte-Duclos, Sotos syndrome, Costello syndrome, Williams syndrome, Alexander disease and fucosidosis. Furthermore a detailed literature review is provided. Macrocerebellum is always associated with an abnormal mental and motor development. Conclusion: Macrocerebellum is a neuroradiological entity that can be identified qualitatively and confirmed quantitatively through volumetric analysis. This is the largest cohort of patients with macrocerebellum described so far. The data available in literature on this entity show that macrocerebellum is not a specific disease but an epiphenomenon found in heterogeneous brain disorders. © Quantitative Imaging in Medicine and Surgery. All rights reserved.
CORRESPONDENCE ADDRESS: D'Arco, F.; Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation TrustUnited Kingdom; email: darcofel@gmail.com