Hemorrhagic Lesions Research Articles

Therapeutic Effects of Edible Desert Truffle Specie (Tirmania nivea) on Hepatogastric Toxicity Induced by Aspirin Treatment in Rats.

Edible mushrooms (Tirmania nivea: Desert truffle specie) are a nutrient-dense source of flavonoids, proteins, fatty acids, minerals, and vitamins. The current study aimed to evaluate the curative effect of an aqueous extract of T. nivea ascocarps against aspirin-induced gastric, liver, and kidney injuries in rats. Hepatogastric disorders induced by aspirin at a dose of 10 mg/kg body weight (BW) treatment in rats and treated with aqueous extract of T. nivea at different doses 25, 50, and 100 mg/kg BW). T. nivea aqueous extract liquid chromatography-mass spectroscopy analysis showed several actives biomolecules such as quinic acid, syringic acid, O-coumaric acid, chlorogenic acid, caffeic acid, luteolin-7-O-glucoside, 4-O-caffeoylquinic acid, and vitamin C. The 1,1-diphenyl-2-picrylhydrazyl radical-scavenging activity revealed significant antioxidant activity (EC50% = 0.6 mg/mL). Aspirin administration caused severe injuries with linear hemorrhagic lesions. The treatment with T. nivea extract ameliorates gastric mucosal structure. The aspirin treatment caused significant increase of alanine aminotransferase and aspartate aminotransferase activities. In curative objective, T. nivea extract significantly corrected the disturbance of liver parameters. Rats given aspirin showed altered liver architecture, apoptosis, and inflammation; in contrast, sections of liver tissue in the rats treated with T. nivea extract at 25 mg/(kg·day) after aspirin administration showed normal liver architecture. A normal architecture was restored once the treatment dose was increased to 50 mg/kg. After 14 days of treatment with 100 mg/(kg·day) of T. nivea extract, aspirin disruptions completely collapse with development of steatosis. On contrary, one week of rat's treatment by aspirin succeed by 2 weeks without any treatment, the histological examination of the kidney showed a dilated capillary and altered Bellini tubes. Normal renal architecture was observed at a dosage of 25 mg/(kg·day) of T. nivea. Extract from T. nivea restored the renal disturbances caused by aspirin.

Hemorrhagic placental lesions on ultrasound: a continuum of placental abruption.

Placental abruption has classically been defined as the premature separation of a normally located placenta before delivery of the fetus. Traditionally, this diagnosis was based on clinical symptoms, including vaginal bleeding, pain, and fetal distress. This definition, however, preceded the advent of obstetric ultrasound. Ultrasound frequently identifies various hemorrhagic lesions, such as retroplacental, subchorionic, intraamniotic, intraplacental, and preplacental hematomas in both symptomatic and asymptomatic patients. These variable ultrasound findings lead to new challenges as to what to define as an abruption, particularly in the absence of symptoms. This ambiguity in defining placental abruption affects clinical decision-making and hinders our understanding of the pathophysiology of abruption, presenting challenges in studying abruption. It is likely that these varying sonographic findings may precede the classic presentation of vaginal bleeding and pain and therefore are often concealed abruptions. This commentary highlights the importance of developing clear diagnostic guidelines for placental abruption, given its association with severe outcomes including a high rate of perinatal mortality and maternal morbidity. We aim to elucidate the complexities of ultrasound diagnosis in placental abruption, advocating for precise criteria to better guide clinical practice. We propose that these ultrasound findings of hemorrhagic placental lesions after 20weeks of gestation in asymptomatic patients should be considered part of the spectrum of abruption, while in symptomatic patients should be taken as confirmation of the diagnosis of abruption.

HISTOPATHOLOGICAL EVALUATION OF PHYLLANTHUS MUELLERIANUS ROOT EXTRACTS: PROTECTIVE EFFECTS ON TISSUES IN LETROZOLE-INDUCED RATS

The histopathological evaluation of kidney, liver, and heart tissues was conducted to investigate the protective and toxicological effects of aqueous and ethanolic root extracts of Phyllanthus muellerianus in rats administered letrozole (LTZ). LTZ-induced damage was characterized by hemorrhagic changes, necrosis, and inflammatory cell infiltration in the kidney, liver, and heart tissues. Treatment with 30 mg/kg body weight of both aqueous and ethanolic extracts showed marked restoration of normal histological features, particularly in the kidney and heart, with reduced cellular degeneration and inflammation. However, higher doses (60 mg/kg and 120 mg/kg) exhibited variable outcomes, including focal necrosis, hemorrhagic lesions, and inflammatory aggregates, particularly in the liver and kidney tissues. These findings highlight the dose-dependent therapeutic and toxicological effects of P. muellerianus root extracts, with lower doses demonstrating significant protective potential against LTZ-induced organ damage. The study underscores the importance of dose optimization in harnessing the therapeutic benefits of P. muellerianus while minimizing potential toxicities. Further research is recommended to elucidate the mechanisms underlying these effects and their implications for clinical application.

Correlation between Types of Bleeding Brain Lesion with Glasgow Coma Scale in Head Injury Patients at Gunung Jati Regional Hospital, Cirebon, Indonesia

Background: Head injuries were a leading cause of morbidity and mortality worldwide, often resulting in bleeding brain lesions such as epidural hematoma, subdural hematoma, subarachnoid hemorrhage, and intracerebral hematoma. The Glasgow Coma Scale (GCS) was a widely used tool to assess the level of consciousness in head injury patients. Understanding this relationship was essential for guiding clinical management and predicting patient outcomes, especially in regions with high incidences of traumatic brain injuries, such as Cirebon, Indonesia. Aims: To analyze the relationship between bleeding brain lesions and the Glasgow Coma Scale in head injuries at Gunung Jati Regional Hospital, Cirebon, Indonesia. Methods: This study used an analytical observational method with a cross-sectional approach. Data collection was conducted using total sampling with a sample size of 28. The inclusion criteria were patients with CT-confirmed brain hemorrhages (epidural, subdural, subarachnoid, or intracerebral hematomas). Data were obtained from medical records in 2023 at Gunung Jati Regional Hospital. The analysis was performed using the Spearman rank correlation test to evaluate the relationship between the type of brain hemorrhage and GCS scores. Results: The total sample of 28 included 21 patients (75%) with Intracerebral Hematoma, 3 patients (10.7%) with Subdural Hematoma, 2 patients (7.1%) with Epidural Hematoma, and 2 patients (7.1%) with Subarachnoid Hematoma. The level of consciousness in these patients was as follows: 15 patients (53.6%) with mild injuries, 8 patients (28.6%) with moderate injuries, and 5 patients (17.9%) with severe injuries. Spearman correlation analysis showed no significant relationship between Bleeding Brain Lesions and Glasgow Coma Scale in head injuries (p =0.645). The absence of correlation might have been due to unaccounted factors in this study, such as hemorrhage volume, lesion location, midline shift, and injury mechanism. Conclusion: There is no significant relationship between types of bleeding brain lesions and Glasgow Coma Scale in head injury patients. The study's limitations included a small sample size and the exclusion of variables such as hemorrhage volume and location, which could affect the level of consciousness. Future research was recommended to involve larger sample sizes and additional clinical factors to better understand the dynamics between types of brain hemorrhages and patients' levels of consciousness, potentially improving clinical management strategies.

Treatment of a Large Hemorrhagic Midbrain Cavernoma Within the Silvian Aqueduct in a Five-Year-Old Girl—A Case Report

Brain stem cavernomas are exceedingly rare in pediatric populations, with limited literature addressing their natural history, treatment guidelines, and counseling. We report the case of a 5-year-old girl presenting with acute neurological symptoms, including diplopia, gait ataxia, headache, and altered consciousness. Initial imaging revealed obstructive hydrocephalus caused by a hemorrhagic lesion near the pineal region. After emergency external ventricular drainage (EVD), most symptoms resolved except for diplopia. A subsequent MRI suggested a space-occupying hemorrhagic cyst in the tectal lamina, leading to endoscopic third ventriculostomy (ETV). During ETV, a large hemorrhagic mass at the aqueduct entrance was identified but not removed due to its fragility. Following ETV, the patient improved rapidly and was discharged. However, she was readmitted with recurrent symptoms and altered consciousness. An emergency MRI indicated a progressive hemorrhagic mass lesion compressing the midbrain, necessitating surgical intervention. The patient underwent suboccipital craniotomy using a telovelar approach. The intraoperative findings included cavernoma-like tissue within the aqueduct, which was successfully resected. Histopathology confirmed hemorrhagic and angiomatous tissue, excluding a primary brain tumor. Postoperatively, the patient showed significant, progressive neurological improvement, with mild internuclear strabism, trunk ataxia, and fatigue at the last follow-up. Six months later, a follow-up MRI and cerebral angiography showed no cavernoma remnants but identified a midbrain deep venous anomaly. This case underscores the feasibility of the microsurgical resection of midbrain cavernomas in symptomatic pediatric patients, highlighting the importance of the thorough assessment of atypical hemorrhagic midbrain lesions to exclude rare vascular malformations from differential diagnoses.

MR findings of intravascular large B-cell lymphoma of the central nervous system: report of three cases.

Intravascular large B-cell lymphoma (IVLBCL) of the central nervous system (CNS) is a rare subtype of diffuse large B-cell lymphoma. Diagnosing CNS-limited IVLBCL is particularly challenging due to its non-specific clinical presentation and laboratory findings. We present three cases of CNS-limited IVLBCL, expanding the understanding of its imaging spectrum and enhancing preoperative diagnostic accuracy. Case 1 involved a 58-year-old male presenting with mild neurological symptoms, initially misdiagnosed as cerebrovascular disease. MRI showed patchy areas of diffusion restriction adjacent to the posterior horn of the left lateral ventricle, progressing over four months to a patchy hemorrhagic lesion in the right temporoparietal region with leptomeningeal enhancement. Case 2 described a 53-year-old male with progressive limb weakness and cognitive decline, initially managed as a demyelinating disease. MRI demonstrated extensive white matter hyperintensities and multiple areas of diffusion restriction. Case 3 involved a 67-year-old female with recurrent cognitive decline and gait disturbance. MRI findings included patchy T2 hyperintensities in the white matter, gyrus-like hyperintensity on T1WI, and punctate and linear enhancement. Cases 1 and 2 were diagnosed as IVLBCL post-biopsy, while in Case 3, IVLBCL was considered based on imaging features and differentiated from CNS vasculitis. These cases highlight the variable and often non-specific MRI characteristics of CNS-IVLBCL, including infarct-like lesions, persistent diffusion restriction, and SWI abnormalities. Early recognition of these imaging findings can aid in timely diagnosis and treatment, potentially improving patient outcomes.

Fundamentals of fetal brain MRI: indications, technique, and normal anatomy.

Magnetic resonance imaging (MRI) evaluation of the fetal central nervous system (CNS) is a well-established imaging modality that improves detection of fetal neuro anomalies. The utilization of rapid imaging acquisition sequences allows for the high-resolution evaluation of the developing fetus with decreased impact from fetal motion. MRI is often performed after a prenatal screening ultrasound (US) demonstrates an abnormality or if there are known risk factors. The most common neurological indications for fetal MRI include ventriculomegaly, absent cavum septum pellucidum, and enlarged cisterna magna followed by hemorrhagic lesions and intracranial cysts. Knowledge of normal fetal anatomy and development of CNS structures is key for accurate interpretation of fetal brain MRI.

Safety and efficacy of a Vero-adapted live attenuated vaccine candidate for African swine fever.

Safety and efficacy of a Vero-adapted live attenuated vaccine candidate for African swine fever.

Natural history, management, and outcomes of cerebellar cavernous malformations: A retrospective study of 130 patients.

Data on the natural history and management of cerebellar cavernous malformations (CMs) is limited. This study aims to identify factors associated with hemorrhage risk, assess management strategies, and compare outcomes between conservative and surgical management in patients with cerebellar CMs. We retrospectively reviewed 130 patients with cerebellar CMs treated at our center (1990-2023). Data on clinical presentation, lesion characteristics, management strategies, and outcomes were analyzed. Annual hemorrhage risk was calculated. Surgical outcomes were assessed based on the persistence of CM-related symptoms and the presence of postoperative complications. Statistical analyses identified factors associated with hemorrhage, symptomatic presentation, and surgical outcomes. Of 130 patients (53.8% female; median age of 48.5 years (IQR: 26.75)), 41 (31.5%) presented with hemorrhage, and 20 (15.4%) had focal neurological deficits. Median lesion size measured 12mm (IQR 8mm) in size and were primarily located in the hemispheres (n = 89, 68.5%), with fewer in the vermis (n = 21, 16.2%), peduncle (n = 20, 15.4%), and dentate nucleus (n = 9, 6.9%). The annual hemorrhage risk for incidental lesions was 1.19%, while rehemorrhage risk for initially hemorrhagic lesions was 8.35%. Surgery was performed in 31 patients (23.8%), mostly for hemorrhage (n = 15, 48.4%) or cerebellar symptoms (n = 7, 22.6%). Postoperative complications were reported in three patients. At a median follow-up of 1.11 years (IQR 5.15 years), 22 patients (18.2%) had persistent symptoms, two developed new symptoms, and two experienced worsening symptoms from hypertrophic olivary degeneration. There was no CM- related mortality, and only one patient experienced moderate CM-related disability (mRS = 3). Cerebellar CMs generally have a benign course with hemorrhage risks compared to supratentorial and brainstem lesions. Conservative management is recommended for incidental lesions, while surgery should be reserved for symptomatic, accessible cases.

Neutrophil-like Cell membrane-Coated Molybdenum-based Nanoclusters for Reduced Oxidative Stress and enhanced Neurological Recovery after Intracerebral Hemorrhage.

Neutrophil-like Cell membrane-Coated Molybdenum-based Nanoclusters for Reduced Oxidative Stress and enhanced Neurological Recovery after Intracerebral Hemorrhage.

Validation of the Boston Criteria Version 2.0 for Cerebral Amyloid Angiopathy in Patients Presenting With Intracerebral Hemorrhage.

Cerebral amyloid angiopathy (CAA) is a leading cause of lobar intracerebral hemorrhage (ICH) in older individuals, associated with significant morbidity and recurrence. The updated Boston criteria version 2.0 (v2.0) incorporate new MRI biomarkers to improve diagnostic accuracy. This study aimed to validate the diagnostic performance of v2.0 compared with version 1.5 (v1.5) in patients with spontaneous ICH undergoing surgical evacuation and brain biopsy. This retrospective single-center cohort study was conducted at the Mount Sinai Health System from 2015 to 2021. Patients with spontaneous ICH who underwent surgical evacuation with brain biopsy and preoperative MRI were included. MRI markers assessed included lobar hemorrhagic lesions (ICH, cerebral microbleeds [CMBs], cortical siderosis [cSS]) and nonhemorrhagic markers (severe visible perivascular spaces in the centrum semiovale [CSO-PVS] and multispot white matter hyperintensities [WMHs]). Pathologic confirmation of CAA was based on modified Vonsattel grading, which evaluates β-amyloid deposition in vessel walls. Diagnostic performance of v2.0 was compared with v1.5 using sensitivity, specificity, and predictive values. Logistic regression models calculated odds ratios (ORs) and 95% CIs for associations between MRI biomarkers and pathologically confirmed CAA. Among 186 patients (median age: 63 years; 38% female), 24% had confirmed CAA. The Boston criteria v2.0 demonstrated higher sensitivity for probable CAA (0.75 vs 0.57) while maintaining specificity (0.96 vs 0.99). For possible CAA, sensitivity improved modestly (0.82 vs 0.77) with comparable specificity (0.84 vs 0.87). Among hemorrhagic markers, cSS (OR 4.14, 95% CI 1.35-13.00, p = 0.013) and lobar CMBs (OR 3.03, 95% CI 1.31-7.10, p = 0.009) were significantly associated with CAA. Among nonhemorrhagic markers, CSO-PVS was strongly associated (OR 5.49, 95% CI 2.37-13.06, p < 0.001) while multispot WMHs were not (OR 1.10, 95% CI 0.45-2.56, p = 0.834). The Boston criteria v2.0 enhance sensitivity for diagnosing probable CAA without compromising specificity, largely due to the inclusion of nonhemorrhagic markers such as CSO-PVS. Limitations include the retrospective design, the absence of formal inter-rater reliability measures, and the modest sample size. These findings underscore the potential of v2.0 to improve the diagnostic framework for CAA.

Investigating Viral Causes of Abortions: A Comprehensive Molecular and Pathological Study on Small Ruminants in East Azerbaijan Province, Iran.

Abortion emerges as a primary concern for small ruminant breeders, leading to substantial economic losses for livestock farmers. The most important factor contributing to abortion in sheep and goats is the presence of infectious agents. The bluetongue virus (BTV), border disease virus (BDV), peste des petits ruminants virus (PPRV), Akabane virus (AKAV) and pox virus are notable viruses responsible for inducing abortion in small ruminants globally. This study focused on the prevalence of viral agents in aborted foetuses and adult sheep and goats with a recent abortion history in East Azerbaijan province, Northwest Iran. For this purpose, a comprehensive evaluation was performed in the nine cities of East Azerbaijan province, Iran. A total of 62 aborted foetuses and 373 blood samples were collected from 43 sheep and goat flocks. The conventional and nested PCR methods were employed for BTV, BDV, PPRV, pox virus and AKAV detection after extracting viral DNA/RNA and cDNA synthesis from the buffy coat (adults) and foetal spleen tissue samples. The formalin-fixed tissue samples from the aborted foetuses were examined histopathologically. Molecular findings revealed that viral infection was present in 7.77% (29 out of 373) of the blood samples and 35.48% (22 out of 62) of the aborted foetuses. Among the blood samples, 1.34%, 2.41% and 4.29% were positive for BTV, BDV and PPR, respectively. No pox virus or AKAV samples tested positive in the adults. In the samples from aborted foetuses, the positivity rates were 12.90%, 25.80%, 9.67%, 1.61% and 0% for BTV, BDV, PPRV, pox virus and AKAV, respectively. Histopathological studies revealed extensive inflammatory reactions associated with severe hyperaemia and haemorrhagic lesions in the tissue sections, particularly in the brain, heart, intestine and spleen, which were more notable in the PCR-positive samples for BTV. In conclusion, the detection of viral agents in both aborted foetuses and blood samples indicates that viral infections play notable roles in the abortion of sheep and goats in East Azerbaijan. Therefore, effective management and vaccination strategies are crucial for preventing and controlling the disease in this region.

Prevalence of coccidiosis in broiler chickens in Medea, Algeria.

Prevalence of coccidiosis in broiler chickens in Medea, Algeria.

First Record of Anguillid Herpesvirus 1 Linked to a Mass Mortality Event in Shortfin Eel (Anguilla bicolor) in Indonesia

Anguillid herpesvirus 1 (AngHV-1), a member of the Alloherpesviridae family, is known to cause high mortality in both wild and farmed eels. Notably, no cases of AngHV-1 infection in Indonesia until June 2023, when a significant mortality rate exceeding 75% among cultured glass eels was documented in Bogor, Indonesia. This study investigated the outbreak by collecting 30 diseased fish from multiple cultured tanks to examine clinical symptoms, histopathological changes, and viral presence through PCR targeting the viral DNA polymerase gene. Hemorrhagic lesions in the abdomen and anal regions were the primary clinical symptoms. Histopathological examination revealed hyperplasia, fusion, and epithelial lifting of the gill secondary lamellae. PCR, using 394 bp primer specific for AngHV-1, confirmed 100% infection among the collected samples, indicating rapid viral transmission within the rearing environment. Phylogenetic analysis of partial DNA polymerase amino acid sequences showed that Indonesian AngHV-1 isolate is genetically diverse and shares similarities with strains from China, Taiwan, Canada, and several European countries, suggesting the emergence of a novel strain. This study highlights the urgent need for enhanced biosecurity measures to curb AngHV-1 spread in the Indonesian eel aquaculture sector.

Central nervous system vascular complications associated with the acute form of steroid-responsive meningitis-arteritis.

Central nervous system vascular complications associated with the acute form of steroid-responsive meningitis-arteritis.

Pseudomonas Infections in the Common Marmoset (Callithrix jacchus): Gross and Histopathological Findings.

Common marmosets (Callithrix jacchus) are a New World nonhuman primate (NHP) whose popularity as a research model continues to expand. Marmosets were identified as the predominant NHP species that is susceptible to spontaneous Pseudomonas infections based on a 27-year survey in a primate colony, encompassing several NHP species. 26 common marmosets were retrospectively identified and evaluated for spontaneous Pseudomonas spp. infections. Clinical symptoms included lethargy, weight loss, gastrointestinal issues (diarrhea, bloating, vomiting, poor appetite), increased respiratory effort, and difficulty urinating. Affected organs (larynx, lungs, liver, gallbladder, intestines, colon, uterus, and urinary bladder) appeared discolored, distended, or enlarged. Microscopic findings included inflammatory infiltrates, edema, necrosis, hemorrhage, and pseudomembranous lesions. Only animals with clinical symptoms or gross evidence of bacterial infection were cultured; therefore, the actual incidence of Pseudomonas spp. infections is unknown. We present the common and uncommon lesions associated with Pseudomonas infections in the common marmoset.

A Deep Learning Segmentation Model for Detection of Active Proliferative Diabetic Retinopathy.

Existing deep learning (DL) algorithms lack the capability to accurately identify patients in immediate need of treatment for proliferative diabetic retinopathy (PDR). We aimed to develop a DL segmentation model to detect active PDR in six-field retinal images by the annotation of new retinal vessels and preretinal hemorrhages. We identified six-field retinal images classified at level4 of the International Clinical Diabetic Retinopathy Disease Severity Scale collected at the Island of Funen from 2009 to 2019 as part of the Danish screening program for diabetic retinopathy (DR). A certified grader (grader1) manually dichotomized the images into active or inactive PDR, and the images were then reassessed by two independent certified graders. In cases of disagreement, the final classification decision was made in collaboration between grader1 and one of the secondary graders. Overall, 637 images were classified as active PDR. We then applied our pre-established DL segmentation model to annotate nine lesion types before training the algorithm. The segmentations of new vessels and preretinal hemorrhages were corrected for any inaccuracies before training the DL algorithm. After the classification and pre-segmentation phases the images were divided into training (70%), validation (10%), and testing (20%) datasets. We added 301 images with inactive PDR to the testing dataset. We included 637 images of active PDR and 301 images of inactive PDR from 199 individuals. The training dataset had 1381 new vessel and preretinal hemorrhage lesions, while the validation dataset had 123 lesions and the testing dataset 374 lesions. The DL system demonstrated a sensitivity of 90% and a specificity of 70% for annotation-assisted classification of active PDR. The negative predictive value was 94%, while the positive predictive value was 57%. Our DL segmentation model achieved excellent sensitivity and acceptable specificity in distinguishing active from inactive PDR.

Reduction of cortical injury using a subdural catheter guidance device: A comparative study on burr hole drainage for chronic subdural hematoma

Chronic subdural hematoma (CSDH) is a chronic hemorrhagic lesion caused by the accumulation of blood between the arachnoid mater and the dura mater. Currently, the most commonly used surgical approach for CSDH is burr hole craniotomy. However, this procedure employs a blind technique, making the cerebral cortex susceptible to injury. The use of a subdural catheter guidance device combined with burr hole drainage in the treatment of CSDH can prevent intraoperative cerebral cortex damage and reduce its potential impact. This study retrospectively analyzed a total of 518 patients with CSDH who underwent surgical treatment at the hospital. Of these, 361 were male (69.69%) and 157 were female (30.31%), with a median age of 59.5 years (range: 12 &amp;ndash; 92 years). All patients underwent preoperative head computed tomography and/or magnetic resonance imaging scans, which revealed crescent-shaped mixed-density or iso-dense shadows beneath the inner table of the skull. Informed consent for the burr hole decompression procedure was obtained from all patients. Subsequently, the 518 patients were randomly divided into two groups: The control group (undergoing the procedure without a &amp;ldquo;guidance device&amp;rdquo;) and the experimental group (undergoing the procedure with a &amp;ldquo;guidance device&amp;rdquo;). All patients provided consent for the publication of their clinical details and related images. In the control group, 274 patients with CSDH were treated, among whom 6 cases had post-operative cortical injury complications, with an incidence rate of 2.19%. In the experimental group, 244 patients with CSDH were treated, and no cortical injury complications occurred post-operatively, with an incidence rate of 0. Fisher&amp;rsquo;s exact test (two-tailed) showed p=0.0427, indicating a significant reduction in cortical injury complications with the use of the guidance device. In addition, the conditional maximum-likelihood estimate (CMLE) odds ratio for Fisher&amp;rsquo;s exact test was 0, with a 95% confidence interval ranging from 0.0 to 0.9447, further reflecting the relationship between the relevant factors. This indicates that incorporating a subdural catheter guidance device during burr hole drainage for CSDH can assist surgeons in avoiding damage to the cerebral cortex.

Research on recognition of diabetic retinopathy hemorrhage lesions based on fine tuning of segment anything model

Diabetic Retinopathy (DR) demands precise hemorrhage detection for early diagnosis, yet manual identification faces challenges due to hemorrhagic lesions’ varied sizes, complex shapes, and color similarities to surrounding tissues, which obscure boundaries and reduce contrast. To address this, we propose SAM-ada-Res, a novel dual-encoder model integrating a pre-trained Segment Anything Model (SAM) and ResNet101. SAM captures global semantic context to distinguish ambiguous lesions from vessels, while ResNet101 extracts fine-grained details through its deep hierarchical layers. Feature maps from both encoders are fused via channel-wise concatenation, enabling the decoder to localize lesions with high precision. A lightweight Adapter fine-tunes SAM for retinal tasks without retraining its backbone, ensuring task-specific adaptation. Evaluated on three datasets (OIA-DDR, IDRiD, JYFY-HE), SAM-ada-Res outperforms state-of-the-art methods in nDice (0.6040 on JYFY-HE) and nIoU (0.4182 on IDRiD), demonstrating superior generalization and robustness. An online platform further streamlines clinical deployment, enhancing diagnostic efficiency. By synergizing SAM’s generalizable vision capabilities with ResNet’s localized feature extraction, SAM-ada-Res overcomes key challenges in DR hemorrhage detection, offering a robust tool for early intervention. This work bridges technical innovation and clinical practicality, advancing automated DR diagnosis.

Cavernous malformations of the optic nerve and chiasm: illustrative case.

Cavernous malformations (CMs) of the optic pathway are rare. In this report, the authors describe a case of a CM affecting bilateral optic nerves that was managed surgically. Additionally, they provide an updated review of the literature focused on the clinical presentation, management, and postoperative outcomes related to this uncommon pathology. A total of 99 cases have been described in the literature, including the case reported. The patient presented with headache, encephalopathy, and bitemporal hemianopia. He was found to have an optic pathway CM and underwent resection of the lesion via a frontotemporal craniotomy. Based on a literature review, the most common presenting symptoms are visual decline and nonspecific headache. Most optic pathway CMs are managed surgically, with improvement in vision seen 66% of the time. CMs of the optic pathway most often present with clinical manifestations of vision loss and headaches. They are difficult to diagnose and can commonly be confused with other hemorrhagic lesions in this region. With a high index of suspicion guided by the clinical and imaging features, one can narrow the differential to include CM. Surgery remains the primary modality of management when symptomatic, similar to intraparenchymal CMs. https://thejns.org/doi/10.3171/CASE24742.