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.

Aim: Trochlear apparatus calcification (TAC) can be an incidental finding in multidetector computed tomography (MDCT) scans. TAC may be misdiagnosed as a foreign body especially in trauma patients. In this study we aim to determine the incidence and types of TAC with cranial and paranasal MDCT scans.Materials and Methods: Consecutive 452 MDCT scans were evaluated retrospectively. Repeated exams and patients with orbital wall fracture history were excluded. CT scans were obtained by a 64-slice scanner with 0.5 mm slice thickness. Reformatted and three-dimension volume rendered images in bone window were used to assess the calcification presence and type.Results: Four hundred forty-one MDCT exams included to study. TACs detected in 31 (7.5%) subjects. TAC was unilateral in 24 (77.4%) and bilateral in seven (22.6%) subjects. There was no significant correlation with aging (p=0.681) and between genders (p=0.808). “Dot-like” TAC was the most common type (n=12, 31.6%). The other types were “inverted-U” (n=11, 28.9%), “linear” (n=8, 21%), “comma” (n=6, 15.6%), respectively. Eight (21%) of TACs were attaching the orbital wall, mostly in “comma” type.Conclusion: The TAC incidence in our study was compatible with literature. Four different types of TAC, including, “dot-like”, “inverted U”, “linear” and “comma” types detected. TACs were usually discrete from the orbital wall however they were occasionally attached. “Linear” type TAC and attachment to orbital wall described for the first time in this study. Knowledge of the TAC appearance may be helpful to differentiate TACs from foreign bodies.