scholarly journals Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy

2017 ◽  
Vol 78 (03) ◽  
pp. e101-e105 ◽  
Author(s):  
Vinicius Trindade ◽  
Marcos Gomes ◽  
Marcelo Santo ◽  
Manoel Teixeira ◽  
Wellingson Paiva
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Sudden Onset ◽  
Surgical Strategy ◽  
Resonance Imaging ◽  
Male Smoker ◽  
Temporal Horn ◽  
Secondary Epilepsy ◽  
Loss Of Contact ◽  
Intracranial Epidermoid ◽  
The Brain

Introduction Epidermoid tumors represent approximately 0.3 to 1.8% of all intracranial brain tumors. Only 1.5% of all intracranial epidermoid cysts (ECs) invade the brain and secondary epilepsy is extremely rare. Since August 2014, a 59-year-old male smoker had been presenting bad smell feelings, totaling four episodes with sudden onset and duration of 2 minutes. On September 2014, after a sense of smell episode, it evolved into loss of contact and automatic movements followed by generalized tonic–clonic movements. The brain magnetic resonance imaging revealed an extensive subtemporal lesion affecting anterior, middle, and posterior fossa with invasion of the choroidal fissure and projection to the temporal horn of the lateral ventricle. Pretemporal craniotomy with combined approaches, transsylvian and subtemporal, allowed for the excision of a white keratinized and softened lesion suggestive of EC. Discussion The optimal surgical strategy in individuals with ECs and seizures is not established. The evaluation of the cause and risk–benefit must be held to choose the appropriate surgical strategy: lesionectomy, lobectomy, or amygdalohippocampectomy. In this case, a lesionectomy was performed due to an absence of evidence of involvement of hippocampus and amygdala. Conclusion Epilepsy secondary to ECs is a rare association. Lesionectomy can be an option with good results without increasing the morbidity.

scholarly journals A study on clinical analysis and surgical outcomes of occipital encephalocele in children

2021 ◽  
Vol 8 (10) ◽  
pp. 2946
Author(s):  
Harisinh V. Parmar ◽  
Nilay S. Adhvaryu ◽  
Jaimin K. Shah ◽  
Bhargav Trivedi ◽  
Milap Parmar
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Clinical Analysis ◽  
Folic Acid Supplementation ◽  
Postnatal Period ◽  
Resonance Imaging ◽  
Occipital Encephalocele ◽  
Csf Leakage ◽  
Poor Neurological Outcome ◽  
The Brain ◽  
Tomography Scan

Background: Occipital encephalocele is the commonest of encephalocele involving protrusion of meningeal and neural structures through the occipital bone defects. It is a congenital anomaly with varied presentation and can include only meninges to the cerebellum, medulla, venous sinus and brainstem structure.Methods: Study was done at civil hospital Ahmedabad from January 2017 to January 2020 occipital encephalocele patients were operated at the department of neurosurgery. The patients were evaluated by computed tomography scan of the brain, magnetic resonance imaging and ultrasound. The operated cases were reviewed and relevant data such as age, sex, location of encephalocele, the size of the lesion, operative method, seizure and hydrocephalus along with postoperative complications were recorded for analysis.Results: In our study, we have better results in contrast to literature may be due to absence of hydrocephalus, other anomalies of brain, seizure disorder and lack of functional brain tissue within the sac as these factors has been associated with poor neurological outcome. Out of 35 operated, 2 patients expired of which 1 patient had other complication at presentation and other one had had developed cerebrospinal fluid (CSF) leakage with ventriculitis.Conclusions: Repair of encephaloceles should be ideally done in the postnatal period to minimize risks of ulceration and trauma to the lesion with subsequent meningitis. We can conclude that folic acid supplementation should be strongly emphasized in health centres to reduce these neural tube defects as none of the patients in our study has taken.

scholarly journals Basal ganglia lesions in subacute sclerosing panencephalitis

2012 ◽  
Vol 6 (4) ◽  
pp. 286-289 ◽  
Author(s):  
Kelson James Almeida ◽  
Sonia Maria Dozzi Brucki ◽  
Maria Irma Seixas Duarte ◽  
Carlos Augusto Gonçalves Pasqualucci ◽  
Sérgio Rosemberg ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Basal Ganglia ◽  
Magnetic Resonance ◽  
Subacute Sclerosing Panencephalitis ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Progressive Dementia ◽  
Etiological Diagnosis ◽  
Basal Ganglia Involvement ◽  
The Brain

ABSTRACT The parieto-occipital region of the brain is the most frequently and severely affected in subacute sclerosing panencephalitis (SSPE). The basal ganglia, cerebellum and corpus callosum are less commonly involved. We describe a patient with SSPE confirmed by neuropathology based on brain magnetic resonance imaging showing extensive basal ganglia involvement and no significant involvement of other cortical structures. Though rarely described in SSPE, clinicians should be aware of this involvement. SSPE should be kept in mind when changes in basal ganglia signal are seen on brain magnetic resonance imaging with or without involvement of other regions of the human brain to avoid erroneous etiological diagnosis of other pathologies causing rapidly progressive dementia.

Occurrence of acute large and edematous callosal lesions in neuromyelitis optica

2009 ◽  
Vol 15 (6) ◽  
pp. 695-700 ◽  
Author(s):  
M Nakamura ◽  
T Misu ◽  
K Fujihara ◽  
I Miyazawa ◽  
I Nakashima ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Medical Records ◽  
Brain Magnetic Resonance Imaging ◽  
Transverse Myelitis ◽  
Resonance Imaging ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Lower Margin ◽  
Chronic Stage ◽  
The Brain ◽  
Extensive Transverse Myelitis

Background The corpus callosum is commonly involved in multiple sclerosis (MS), but the characteristics of callosal lesions in neuromyelitis optica (NMO) are unknown. Objective To reveal the features of callosal lesions in NMO in comparison to MS. Methods We retrospectively reviewed the medical records and the brain magnetic resonance imaging films of 56 patients with MS and 22 patients with NMO. Results In MS, 36 (64.3%) of 56 patients had callosal lesions, but only four patients had acute lesions. All such acute lesions were small, isolated and non-edematous, and the intensity was homotonic. Chronic lesions were observed in 34 patients with MS, and 32 (94%) of them presented small lesions located at the callosal lower margin (“hemi-oval pattern”). Meanwhile, four (18.2%) patients with NMO had callosal lesions, and three of them had acute lesions. Those acute lesions were multiple, large edematous ones with heterogeneous intensity (“marbled pattern”). In the chronic stage, the lesions shrank or disappeared. Conclusions Acute large, edematous callosal lesions occasionally occur in NMO. Similar to longitudinally extensive transverse myelitis, such callosal lesions may reflect severe edematous inflammation in NMO, and may provide additional evidence that the pathogenesis in NMO is different from that in MS.

scholarly journals Conservative management of a fourth ventricular epidermoid in a patient with Gardner syndrome

2020 ◽  
Vol 1 ◽  
pp. 263300402096970
Author(s):  
Gordon D. Heller
Keyword(s):  
Case Report ◽  
Conservative Management ◽  
Epidermoid Cyst ◽  
Fourth Ventricle ◽  
Resonance Imaging ◽  
Gardner Syndrome ◽  
Magnetic Resonance Imaging Mri ◽  
Intracranial Epidermoid ◽  
Brain Cysts ◽  
The Brain

Gardner Syndrome is a rare disease with clinical manifestations of familial intestinal polyposis with osteomas. Cutaneous and subcutaneous lesions are common and epidermoid cyst is a characteristic dermatologic finding. This case report presents a novel finding of an intracranial epidermoid situated in the fourth ventricle in a patient with Gardner Syndrome. This intracranial epidermoid has been followed with sequential magnetic resonance imaging (MRI) for 10 years with progressive growth of the lesion. This suggests the conservative management is an option in patients with an enlarging epidermoid cyst in the fourth ventricle. Plain language summary Non-operative treatment of a cyst in the brain in a syndrome called Gardner syndrome. What is Gardner syndrome? Gardner syndrome is a rare disease and form of familial adenomatous polyposis (FAP) that is characterized by multiple small growths of cells (polyps) in the colon and various types of tumors, both noncancerous (benign) and cancerous (malignant). It is caused by changes (mutations) in the APC gene. Abnormal changes on the skin and under the skin are common as well as growths called epidermoid cysts. The cysts develop when cells that are meant to become skin, hair, and nails (epithelial cells) are trapped among the cells that form the brain. Epidermoid brain cysts may be diagnosed by magnetic resonance imaging (MRI) and computerized tomography (CT) scans. Typical treatment usually involves surgery. What was the aim of this case report? To present a different management strategy for patients with Gardner Syndrome with epidermoid brain cysts. How was this patient treated? This patient is the first patient with Gardner Syndrome with a very rare epidermoid brain cyst reported to be treated in a conservative manner. The patient was monitored for 10 years with regular MRI scans and the cyst continued to grow over this time. Despite this growth the patient has shown no signs of a buildup of fluid in the cavities deep within the brain (called hydrocephalus). The patient experienced nonfocal headaches, which were relieved with medication so doctors decided not to surgically remove the cyst. Why is this case important? Conservative management of epidermoid brain cysts in Gardner patients has not been reported before. This case report shows that conservative management may be an alternative option for patients with a growing epidermoid cyst in the fourth ventricle of the brain. Conservative treatment is designed to avoid invasive treatments or surgery and provides a different option for patients who are unable to have surgery.

Psychosis as presenting symptom in adult-onset Hallervorden-Spatz syndrome

2007 ◽  
Vol 19 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Marios Panas ◽  
Konstantinos Spengos ◽  
Georgios Koutsis ◽  
Georgios Tsivgoulis ◽  
Konstantinos Sfagos ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Magnetic Resonance Imaging ◽  
Adult Onset ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Psychiatric Symptomatology ◽  
Extrapyramidal Signs ◽  
Wheel Chair ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Background:Hallervorden-Spatz syndrome is characterized by pyramidal and extrapyramidal signs, and dysarthria and dementia. Psychiatric symptomatology can emerge in the course of the disorder. Mutations in the pantothenate kinase 2 gene have been found in many cases. We report a case with psychosis as sole presenting symptom.Case:A 41-year-old man presented with change in behavior and paranoid delusional ideation. Six months later, spasticity, extrapyramidal rigidity and dysarthria were added to the picture. Eventually, the patient became mute and wheel-chair bound. The brain magnetic resonance imaging (MRI) was consistent with iron depositions in the globus pallidus and substantia nigra.Conclusions:In this case, the combination of clinical and MRI findings was consistent with Hallervorden-Spatz syndrome. The combination of psychiatric and MRI findings should lead to further neurological investigation.

Hypotension and Brain Injury in Asphyxiated Newborns Treated with Hypothermia

2017 ◽  
Vol 35 (01) ◽  
pp. 031-038 ◽  
Author(s):  
Asim Al Balushi ◽  
Stephanie Barbosa Vargas ◽  
Julie Maluorni ◽  
Priscille-Nice Sanon ◽  
Emmanouil Rampakakis ◽  
...  
Keyword(s):  
Brain Injury ◽  
Brain Magnetic Resonance Imaging ◽  
Severe Brain Injury ◽  
Resonance Imaging ◽  
Increased Risk ◽  
Blood Pressures ◽  
Magnetic Resonance Imaging Mri ◽  
Lactate Levels ◽  
The Impact ◽  
The Brain

Objective This study aimed to assess the incidence of hypotension in asphyxiated newborns treated with hypothermia, the variability in treatments for hypotension, and the impact of hypotension on the pattern of brain injury. Study Design We conducted a retrospective cohort study of asphyxiated newborns treated with hypothermia. Mean blood pressures, lactate levels, and inotropic support medications were recorded during the hospitalization. Presence and severity of brain injury were scored using the brain magnetic resonance imaging (MRI) obtained after the hypothermia treatment was completed. Results One hundred and ninety term asphyxiated newborns were treated with hypothermia. Eighty-one percent developed hypotension. Fifty-five percent of the newborns in the hypotensive group developed brain injury compared with 35% of the newborns in the normotensive group (p = 0.04). Twenty-nine percent of the newborns in the hypotensive group developed severe brain injury, compared with only 15% in the normotensive group. Nineteen percent of the newborns presenting with volume- and/or catecholamine-resistant hypotension had near-total injury, compared with 6% in the normotensive group and 8% in the group responding to volume and/or catecholamines. Conclusion Hypotension was common in asphyxiated newborns treated with hypothermia and was associated with an increased risk of (severe) brain injury in these newborns.

Headache and Hemiparesis in Middle Age

2021 ◽  
pp. 189-191
Author(s):  
Catalina Sanchez Alvarez ◽  
Kenneth J. Warrington
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Cerebral Artery ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Primary Angiitis ◽  
The Central Nervous System ◽  
The Brain

A 53-year-old man with hypertension, hyperlipidemia, and a remote, cryptogenic, multifocal, posterior circulation ischemic stroke, came to the emergency department with 1 day of vertigo, ataxic gait, nausea, occipital headache, and painless binocular diplopia. Symptoms were present upon awakening on the day of presentation and progressed throughout the day. The erythrocyte sedimentation rate was 10 mm/h and C-reactive protein level was less than 3 mg/L. Cerebrospinal fluid examination indicated mild lymphocytic pleocytosis with 9 cells/µL, protein value of 45 mg/dL, and glucose level within normal limits. Brain magnetic resonance imaging and magnetic resonance angiography with contrast demonstrated a left caudate head infarction and leptomeningeal and perivascular enhancement involving bilateral temporal lobes, basal ganglia, and frontal lobes. Right middle cerebral artery wall enhancement was also noted. Conventional cerebral angiography showed diffuse dilatation and mural irregularity of the right middle cerebral artery M1 segment, as well as dilatation of the first 2 mm of the left anterior cerebral artery A1 segment. These findings were associated with vessel wall gadolinium enhancement on magnetic resonance imaging, which raised concern for vasculitis. The patient was diagnosed with primary angiitis of the central nervous system. The diagnosis was based on the presence of multiple ischemic infarcts, without cardioembolic source, abnormal brain magnetic resonance imaging and magnetic resonance angiography findings consistent with vasculitis, and the absence of systemic vasculitis, infection, and cancer. After diagnosis, the patient was started on intravenous methylprednisolone, followed by oral prednisone and intravenous cyclophosphamide. Because of some new areas of enhancement on magnetic resonance imaging, the patient was subsequently treated with rituximab. Clinical and radiologic remission was achieved, although the patient had permanent residual gait difficulties. Central nervous system vasculitis is an inflammatory process of the blood vessels in the brain, meninges, and spinal cord. It is called primary angiitis of the central nervous system when the process is limited to the brain and, rarely, the spinal cord. In other circumstances, central nervous system vasculitis can be secondary to a systemic inflammatory syndrome or infectious process.

scholarly journals Cardiac Arrest due to Butane Gas Inhalation in an 18 Years Old Boy

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Abdulaziz A. AlRabiah ◽  
Abdulmalik M. AlShamrani ◽  
Afnan A. AlMass
Keyword(s):  
Life Support ◽  
Memory Loss ◽  
Advanced Cardiac Life Support ◽  
Spontaneous Circulation ◽  
Resonance Imaging ◽  
Male Smoker ◽  
Gas Inhalation ◽  
Magnetic Resonance Imaging Mri ◽  
Electroencephalogram Eeg ◽  
The Brain

An 18-year-old male smoker inhaled butane gas out of a pocket lighter with his friend for the purpose of changing his voice. He suddenly collapsed and lost his consciousness. Upon arrival to the Emergency Department, he was found pulseless with a rhythm of ventricular fibrillation. Cardiopulmonary resuscitation (CPR) was initiated according to the advanced cardiac life support (ACLS) protocol for three cycles until return of spontaneous circulation archived. After extubation, the patient was ataxic and had significant memory loss and severe confusion. Days later he improved and was discharged with walking aid for his ataxia and a plan to followup with the neurology team for magnetic resonance imaging (MRI) of the brain and electroencephalogram (EEG) as an outpatient.

Sign in / Sign up

Export Citation Format

Share Document