A wide variety of disease patterns are found in the practice of neurology, which has led to the development of numerous advanced MR (Magnetic Resonance) imaging techniques. Some techniques such as DWI have found such widespread application that they have been incorporated into nearly all-imaging protocols for a variety of neurological conditions, and yet others are used to answer specific clinical questions. The advent of higher strength MR magnets have allowed for clinical application of exciting new MR techniques like BOLD fMRI imaging, DTI, and ASL perfusion. The subsequent sections briefly highlights various advanced imaging technique and its clinical application.

Microcephaly is an autosomal recessive neuro developmental disorder in which affected individual characterized by microcephaly present at birth and non-progressive mental retardation. In primary microcephaly, head circumference of the affected person shows variation from >3S D in normal population and in very rare cases non progressive mental retardation seen in affected individual [1-2]. Primary microcephaly is due to mutations in at least twelve lociat autosomal chromosome, which result in different phenotypes [3]. Persons with primary microcephaly have reduced skull consequently smaller brain but brain a architecture is quite normal as in normal person, the darker portion of brain (Gray matter)remain greatly preserved due to which no neurological abnormalities had seen such as abnormal muscle reflex, inability in speaking etc., but mild to severe mental retardation had been observed [4]. Recently it is identified that mutation in a new geneisal so involved in causing dominant microcephaly named as kinesine family member 11 (KIF11) which is reported in 16 families worldwide. It is firmly believed that due to mutations in the segenes ultimately lead to following consequences like in term it tent mitotic spindle fibers, transcriptional regulation, premature condensation, DNA aberration and many other problems which are not visible yet [5].

Objectives: P-Glycoprotein (P-gp) an efflux transporter localized in the blood-brain barrier, influences drug concentrations in the brain and thereby their clinical efficacy. P-gp knockout mice differ markedly from wild type animals with respect to pharmacokinetics and -dynamics of P-gp substrates. Using the P-gp substrate risperidone as a model drug, we studied the effects of P-gp induction on drug concentrations in blood and CNS as well as its effects on drug related behavior.

Methods: P-gp inducing drugs dexamethasone and 5-pregnene-3beta-ol-20-on-16alpha-carbonitrile (PCN) were given to FVB/N mice for 11 days. Control mice received vehicle only. On day 12, risperidone was injected i.p. For kinetic investigations, brain and serum levels of risperidone and 9-hydroxyrisperidone were measured by reversed phase-high performance liquid chromatography with spectrophotometric detection. To study pharmacodynamic effects, risperidone induced RotaRod behavior was analysed with Rota Rod.

Results: Risperidone and 9-hydroxyrisperidone concentrations were decreased in the blood serum and brain homogenate of animals treated with dexamethasone or PCN. Baseline Rota Rod behavior was only slightly affected by P-gp inducing drugs. Rota Rod deficits due to risperidone were markedly reduced after induction of P-gp by both drugs.

Conclusion: Induction of P-gp diminishes the CNS effects of drugs characterized as substrates of P-gp. Therefore, it seems likely that induction of P-gp by co-medication has the potential to minimize treatment response and increase potential side effects of CNS drugs in a clinical respect.

The fact that the brain is protected by the skull, the meninges and that the material which can enter is controlled by the Blood-Brain -Barrier (BBB) for bidirectional traffic is causing obstacles to the physicians in cases that remedy is needed for tumors, infections and dysfunction of the very complicated neuron cycles, billions of them, controlling all functions of life. Diagnosis is meeting great difficulties and nowadays only spectroscopy, with its latest development we can count the sound, which can give us the vague picture of what is happening inside the skull. Photo acoustic angiography is only one ultramodern way to understand the inner brain, two electrons fluorescence spectroscopy is also one of the method second to positron tomography. In all these cases, chemical agents are introduced to the sinner brain overcoming the BBB obstacle. Remedy by applying drugs is very often used either to cure tumors and infections and t5o repair neurologic dysfunction. The BBB is in all these cases a major issue to handle. In this mini review, we would like to update the reader on the confrontation with the BBB issue.

Objective: This is a retrospective study. Our aim was to analyze the characteristics of SCI patients with HO and the risk factors associated with HO formation.

Materials-Methods: Hospital records of the inpatient SCI patients, treated between 2011-2012 at our hospital, were analyzed and the ones with HO development were identified. The demographic and clinical characteristics (neurological level and severity of injury according to ASIA/ISCoS Standards and ASIA Impairment Scale (AIS) of the patients, HO localization, presence of spasticity were evaluated, descriptive statistics were used to analyze the results.

Results: Three hundred fifty five SCI patients’ data were investigated and forty (11%) of them (77.5%, male and 22.5% female) were found to have HO. The mean age was 40.85±17.40 years; the median duration of the injury was 24 months. 42.5 % of the patients were tetraplegic, 57.5 % were paraplegic. Half of the patients had complete (AIS A n: 20) injury. Thirty two patients were traumatic and 8 were non-traumatic in etiology. The knee and hip joints were the most frequently affected joints (47.5% and 42.5% respectively). Spasticity was found in 34 patients (85%).

Conclusion: The incidence and localization of HO in this group were in correlation with the published reports. The knee and hip location of HO and traumatic etiology were found most frequently. However unlike previous reports HO was more frequent in paraplegic patients. The identification of characteristics of the SCI patients and risk factors associated with HO can help to reduce the incidence.