Background and Objectives: This study was performed for the purpose of assessing whether antiepileptic levetiracetam treatment produces a change in brain volumes in children with epilepsy. To that end, we compared the volumes of the basal ganglia (caudate nucleus, putamen, globus, hip-pocampus, and thalamus) at magnetic resonance imaging (MRI) before and after treatment (months 18–24) in pediatric epilepsy patients using levetiracetam. Materials and Methods: This retrospective study involved a volumetric comparison of patients presenting to the Balikesir University Medical Faculty pediatric neurology clinic between 01.08.2019 and 01.11.2023 and diagnosed with epilepsy, and who underwent cranial MRI before and 18–24 months after treatment at the radiology department. The demographic and clinical characteristics (age, sex, family history of epilepsy, type of epilepsy, and EEG features (normal, abnormal, epileptiform)) of the patients included in the study were recorded. Results: The comparison of basal ganglia volumes at cranial MRI before and at months 18–24 of treatment revealed significant differences in the left caudate nucleus, right putamen, left putamen, left globus pallidus, right thalamus, left thalamus, and right hippocampal regions. Conclusions: In conclusion, differing findings are encountered at cranial imaging in patients with epilepsy, depending on the seizure frequency, activity, and the type of antiepileptic drugs used. This study compared basal ganglia volumes on cranial MRIs taken before and 18–24 months after treatment in pediatric epilepsy patients using levetiracetam. A significant increase was observed in the volumes of basal ganglia (caudate nucleus, putamen, globus pallidus, hippocampus, and thalamus) on the MRIs of pediatric epilepsy patients using levetiracetam.

Paraneoplastic neurological syndromes are rare immune-mediated disorders that may develop independently of tumor stage or metastatic spread. Limbic encephalitis is an uncommon manifestation, and its occurrence in association with head and neck cancers is exceptionally rare. We describe a 42-year-old man who presented with subacute ataxia, tremor, dysarthria, and altered consciousness. Brain magnetic resonance imaging revealed hyperintensities in the left hippocampus, parahippocampal gyrus, and amygdala, while cerebrospinal fluid analysis demonstrated lymphocytic pleocytosis, elevated protein levels, oligoclonal bands, and positivity for anti-Yo antibodies. Concomitant imaging identified a nasopharyngeal mass, which was subsequently confirmed as keratinizing nasopharyngeal carcinoma. The patient was treated with high-dose intravenous corticosteroids and immunoglobulin, resulting in complete neurological and radiological recovery. To our knowledge, this is the first reported case of anti-Yo positive paraneoplastic limbic encephalitis associated with nasopharyngeal carcinoma, underscoring the importance of considering paraneoplastic etiologies in atypical neurological presentations and demonstrating the potential for favorable outcomes with timely immunomodulatory therapy.

Objectives: To investigate morphometric alterations associated with pediatric migraine without aura at the whole-brain, cerebellar subregional, and thalamic nuclei levels using a multiplatform magnetic resonance imaging (MRI) approach integrating the complementary strengths of different neuroimaging platforms. Methods: This retrospective study included 74 patients aged 12–17 years with migraine without aura and 70 control subjects with structurally normal cranial MRI findings. High-resolution isotropic three-dimensional T1-weighted MRI datasets were analyzed using a multiplatform segmentation workflow integrating vol2Brain, FreeSurfer, and 3D Slicer. Multiple comparisons were corrected using the Benjamini–Hochberg false discovery rate method. Significant volumetric measurements were subsequently normalized for total intracranial volume (TIV) and reanalyzed. Results: Compared with controls, patients with migraine exhibited lower bilateral amygdala and right thalamic volumes, as well as reduced cortical thickness in the right anterior insula, left anterior cingulate gyrus, and precuneus (all FDR-adjusted q < 0.05). Cerebellar analyses demonstrated reduced bilateral Lobule VI volume and gray matter volume, together with cortical thinning in the right Crus I and right Crus II (all FDR-adjusted q < 0.05). Thalamic nuclei analyses revealed lower volumes of the bilateral mediodorsal and pulvinar nuclei and the right ventral anterior and ventral posterolateral nuclei (all FDR-adjusted q < 0.05). All volumetric findings remained significant after TIV normalization. Conclusions: By integrating whole-brain morphometry with detailed cerebellar subregional and thalamic nuclei analyses, this study expands conventional morphometric assessment and provides a more integrated perspective on structural brain alterations associated with pediatric migraine without aura.

The persistent trigeminal artery (PTA) is a persistent, primitive, embryonic anastomosis that provides the blood flow between the vertebro-basilar system and the carotid system. The presence of PTA anastomosis may create an advantage by providing collateral circulation during a stroke as in cases of leptomeningeal collaterals, external-internal carotid artery anastomoses, and the polygon of Willis. However, patients with this variation are more susceptible to the development of non-occlusive posterior arterial system infarction when they experience hypotension attacks. In the literature, there are only few case reports on non-occlusive posterior system infarction associated with PTA variation. In this case report, we present to an 81-year-old patient with posterior system infarct findings and persistent trigeminal artery variation.

Temporal lifting is widely performed as an aesthetic procedure with a generally favorable safety profile, yet rare and clinically significant complications may arise due to the anatomical continuity between the temporal region and deep cervical spaces. This report presents an uncommon case in which a healthy woman developed a rapidly progressive sequence of middle temporal vein thrombophlebitis, multicompartment deep neck infection, and Lemierre syndrome (an infectious thrombophlebitis of the internal jugular vein often leading to systemic septic embolization) shortly after temporal lifting. Her symptoms evolved from localized temporal discomfort to trismus, swallowing difficulty, and extensive cervical inflammatory spread, prompting suspicion for deep neck involvement. Magnetic resonance imaging provided critical diagnostic clarity by demonstrating venous thrombosis, diffuse soft tissue infiltration, and narrowing of the parapharyngeal airway. Early administration of broad spectrum antimicrobial therapy, therapeutic anticoagulation, and close respiratory monitoring resulted in full clinical recovery. This case emphasizes that even superficially performed facial rejuvenation procedures may trigger extensive infectious and vascular processes through established fascial pathways. To the best of current knowledge, this is the first reported occurrence of the combined presentation of temporal venous thrombophlebitis, widespread deep neck infection, and Lemierre syndrome following temporal lifting. These observations highlight the importance of early imaging and clinical vigilance in patients presenting with disproportionate postoperative symptoms.