Incidental subcutaneous nodules on the scalp in patients undergoing CT of the brain; frequency, appearance, and differential diagnosis

2010 ◽  
Vol 65 (5) ◽  
pp. 427-428 ◽  
Author(s):  
J. Gossner ◽  
J. Larsen
1984 ◽  
Vol 29 (2) ◽  
pp. 132-134 ◽  
Author(s):  
L.B. Raschka

Most violence connected with sleep disorder is assumed to be related to sleep walking. It is less well known that other sleep disorders can also give rise to violence. The role of narcolepsy in car accidents is mentioned. Sleep drunkenness can lead to confusion resulting in violent behaviour especially on forced awakening. This condition is associated to sleep apnea. Primary or central sleep apnea is caused by disorders of the brain stem affecting the respiratory center. Secondary or upper airway sleep apnea can be caused by virtually any condition that results in cessation of the airflow due to occlusion of the upper airway. The author describes one patient who engaged in assaultive behaviour on forced awakening following earlier alcohol consumption. The pathomechanism of violent behaviour generated by a combination of sleep apnea and respiratory pathology is described. The differential diagnosis, prevention and treatment is outlined. The use of polysomnography in diagnosis and the potentially dangerous effects of drugs with respiratory depressing effects is highlighted.


2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures


1998 ◽  
Vol 56 (4) ◽  
pp. 803-807 ◽  
Author(s):  
PAULO HENRIQUE AGUIAR ◽  
WEI LIU CHING ◽  
HELIO LEITÃO ◽  
F. ISSA ◽  
GUILHERME LEPSKI ◽  
...  

Cerebral hemiatrophy or Dyke-Davidoff-Masson syndrome is a condition characterized by seizures, facial asymmetry, contralateral hemiplegia or hemiparesis, and mental retardation. These findings are due to cerebral injury that may occur early in life or in utero. The radiological features are unilateral loss of cerebral volume and associated compensatory bone alterations in the calvarium, like thickening, hyperpneumatization of the paranasal sinuses and mastoid cells and elevation of the petrous ridge. The authors describe three cases. Classical findings of the syndrome are present in variable degrees according to the extent of the brain injury. Pathogenesis is commented.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haiting Qin ◽  
Ye Qiu ◽  
Yanmei Huang ◽  
Mianluan Pan ◽  
Dong Lan ◽  
...  

Abstract Background Talaromyces marneffei (TM) primarily infects patients with co-morbidities that cause immunodeficiency, but non-secretory myeloma (NSMM) is rare. TSM and NSMM are associated with fever, osteolysis, and swollen lymph nodes, thereby making it difficult for clinicians to make differential diagnosis. In this case, we describe TM infection coexisting with NSMM. Case presentation We retrospectively reviewed the case of a male (without human immunodeficiency virus infection) with fever, thoracalgia, swollen lymph nodes, and subcutaneous nodules who presented to the First Affiliated Hospital of Guangxi Medical University in February 2014. Chest computed tomography revealed patchy infiltration and positron emission tomography/computed tomography showed increased metabolic activity in the lower-right lung, lymph nodes, left ninth rib, and right ilium. Pathological examination of the lung, lymph nodes, subcutaneous nodules, and bone marrow showed no malignancy, he was diagnosed with community-acquired pneumonia. His clinical symptoms did not improve after anti-bacterial, anti-Mycobacterium tuberculosis, and anti-non-M. tuberculosis treatment. Later, etiological culture and pathological examination of the subcutaneous nodule proved TM infection, and the patient was re-diagnosed with disseminated TSM, which involved the lungs, lymph nodes, skin, bone, and subcutaneous tissue. After antifungal treatment, the patient showed significant improvement, except for the pain in his bones. Imaging showed aggravated osteolysis, and bone marrow biopsy and immunohistochemistry indicated NSMM. Thus, we conclusively diagnosed the case as NSMM with TSM (involving the lungs, lymph nodes, skin, and subcutaneous tissue). His condition improved after chemotherapy, and he was symptom-free for 7 years. Conclusion TM infection is rare in individual with NSMM. Since they have clinical manifestation in common, easily causing misdiagnosis and missed diagnosis, multiple pathological examinations and tissue cultures are essential to provide a differential diagnosis.


2019 ◽  
Vol 10 ◽  
pp. 72 ◽  
Author(s):  
Edvin Telemi ◽  
Nikolay L. Martirosyan ◽  
Mauricio J. Avila ◽  
Ashley L. Lukefahr ◽  
Christopher Le ◽  
...  

Background: Pleomorphic xanthoastrocytoma (PXA) is a rare form of astrocytic neoplasm most commonly found in children and young adults. This neoplasm, which is classified as a Grade II tumor by the World Health Organization classification of tumors of the central nervous system, carries a relatively favorable outcome. It is usually found supratentorially in cortical regions of the cerebral hemispheres, and as such, presenting symptoms are similar to other supratentorial cortical neoplasms; with seizures being a common initial symptom. Due to the rarity of this type of neoplasm, PXA arising elsewhere in the brain is often not included in the initial differential diagnosis. Case Description: This report presents an extremely rare patient with PXA arising in the suprasellar region who presented with progressive peripheral vision loss. Magnetic resonance imaging of the brain demonstrated a heterogeneous suprasellar mass with cystic and enhancing components initially; the most likely differential diagnosis was craniopharyngioma. The patient underwent endoscopic endonasal resection of the tumor. Microscopically, the tumor was consistent with a glial neoplasm with variable morphology. Based on these findings along with further immunohistochemical workup, the patient was diagnosed with a PXA arising in the suprasellar region. At the 1-year follow-up, the patient remained free of recurrence. Although rare PXA originating in other uncommon locations, such as the spinal cord, cerebellum, the ventricular system, and the pineal region have been previously described. Conclusion: Although rare, PXA should be included in the differential diagnosis for solid-cystic tumors arising in the suprasellar region in young adults.


2008 ◽  
Vol 12 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Susan M. Poelman ◽  
Khue Nguyen

Background: Pancreatic panniculitis is a rare entity, occurring in less than 2% of patients with pancreatic disorders. Skin manifestations may precede the diagnosis of a pancreatic disease by many months. When treatable, correction of the underlying pancreatic disorder may lead to prompt resolution of the panniculitis. Objective: We present the case of a 74-year-old-man with a history of chronic pancreatitis who presented with an acute onset of tender, nonulcerating nodules. The clinical and histologic features of pancreatic panniculitis are discussed, with a brief review of the differential diagnosis and clinical approach to panniculitis. Conclusions: Pancreatic panniculitis is a recognizable clinical entity with characteristic histologic features that may resolve with treatment of the underlying pancreatic disorder. The algorithm-based clinical approach to panniculitis presented in this study is a practical tool designed to guide clinicians in ordering investigations and determining the appropriate management for patients presenting with subcutaneous nodules.


2020 ◽  
Author(s):  
Yiwei Zhang ◽  
Han Wang ◽  
Dan Xu ◽  
Bo Hou ◽  
Tianye Lin ◽  
...  

Abstract Background: To compare brain morphological differences in progressive supranuclear palsy (PSP), multiple system atrophy with the parkinsonian variant (MSA-P), Parkinson’s disease (PD) and controls by manual and automated measurements and to explore the feasibility of these measurements in disease differentiation.Methods: Ninety-five PSP patients (48 males, mean age 67.9 y), 32 MSA-P patients (18 males, mean age 63.0 y), 136 PD patients (72 males, mean age 66.6 y) and 100 controls (50 males, mean age 66 y) were included. The 12 manual measurements were acquired. Relative brain structural volumes adjusted according to the intracranial volume (ICV) of different brain regions werealsoquantified. Differences among and between groups were evaluated. Receiver operating characteristic curve analysis was used to assess diagnostic performance and define cutoff values of these measures.Results: P/M area 2.0displayed the highest diagnostic performance (AUC: 0.801) for distinguishing PSP from MSA-P or PD (sensitivity69.5%, specificity 82.1%). Furthermore, the combination of morphological features in manual parameters (P/M area 2.0, MRPI and M/P diameter) and volume atrophy in the midbrain improved the PSP discrimination (AUC: 0.870, sensitivity 76.8%, specificity 83.9%). The relative volume of the putamen can better differentiate MSA-P from PSP and PD (AUC: 0.844, sensitivity 81.3%, specificity 75.3%). Similarly, the ability to differentially diagnose MSA-P increased most significantly (AUC: 0.927, sensitivity 87.5%, specificity 87.9%) when combing volume atrophy in the putamen with the caudate and manual parameter (M/P diameter).Conclusion: Manual and automated MR variables can reveal atrophy features of the brain and be helpful in the differential diagnosis.


Author(s):  
Daniel Abásolo ◽  
Javier Escudero ◽  
Roberto Hornero ◽  
Pedro Espino ◽  
Carlos Gómez

Alzheimer’s disease (AD) is the most frequent cause of dementia in western countries, and is characterized by progressive impairments in cognition and memory, whose course lasts several years prior to death (Jeong, 2004). These clinical features are accompanied by histological changes in the brain, which include widespread cortical atrophy, intracellular deposition of neurofibrillary tangles, and extracellular deposition of senile plaques, particularly in the hippocampus and the cerebral cortex. Although a definite diagnosis is only possible by necropsy, a differential diagnosis with other types of dementia and with major depression should be attempted. Magnetic resonance imaging and computerized tomography can be normal in the early stages of AD, but a diffuse cortical atrophy is the main sign in brain scans. Mental status tests are also useful.


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