scholarly journals An Unusual Dermoid Cyst of the Pineal Region. Case report in a Child

2020 ◽  
Author(s):  
Mohammad Jamali ◽  
Iman Ahrari ◽  
Arash Saffarrian ◽  
Keyvan Eghbal ◽  
Abbas Rakhsha ◽  
...  
Keyword(s):  
Dermoid Cyst ◽  
Pineal Region ◽  
Endoscopic Biopsy ◽  
Radical Excision ◽  
Case Presentation ◽  
Common Location ◽  
Adjacent Structures ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Abstract Introduction The pineal gland is a common location for intracranial germ cells, but dermoids are not commonly observed in this area. In the present paper, we discuss the clinical and radiological features as well as the treatment and outcome of this cyst in a 6-year- old child with a pineal dermoid cyst. Case Presentation The patient presented with chronic headache 6 months before admission in 2018. On the first admission, an enhanced lesion with a small cyst was detected in brain imaging. Magnetic resonance imaging (MRI) of the brain at follow-up (2 months after the first presentation) showed enlargement of the cyst size with compression on the adjacent structures. Radical excision of the tumor was performed after the endoscopic biopsy due to pressure exerted on the adjacent structures. Conclusion Dermoid cyst should be considered as a differential diagnosis for enhanced lesions of the pineal region.

Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

2021 ◽  
Author(s):  
Zahra Tavoli ◽  
Ali Montazeri
Keyword(s):  
Renal Agenesis ◽  
Primary Diagnosis ◽  
Case Presentation ◽  
Uterus Didelphys ◽  
Future Fertility ◽  
History Of ◽  
Ohvira Syndrome ◽  
Obstructed Hemivagina ◽  
Magnetic Resonance Imaging Mri

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications. Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea. Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility.

Lateral Medullary Infarction with Contralateral Segmental Dysesthesia and Ipsilateral Headache: A Case Report

2021 ◽  
Vol 17 ◽  
Author(s):  
Renjie Wang ◽  
Yankun Shao ◽  
Lei Xu
Keyword(s):  
Medulla Oblongata ◽  
Clinical Manifestations ◽  
Lateral Medullary Infarction ◽  
Case Presentation ◽  
Specific Sign ◽  
Temperature Sense ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
The Brain ◽  
Medullary Infarction

Introduction: The medulla oblongata is the lowest segment of the brain stem, located adjacent to the spinal cord, with a complex anatomical structure. Thus, a small injury to the medulla oblongata can show complex clinical manifestations. Case Presentation: A patient experienced dysesthesia, which manifested as numbness in her right lower limb and decreased temperature sense, and dizziness 20 days before admission. The numbness worsened 1 week before admission, reaching the right thoracic (T) 12 dermatomes. Her thermoception below the T12 dermatomes decreased, and the degree of dizziness increased, accompanied by nausea and vomiting. Magnetic resonance imaging (MRI) of the neck, chest, and abdomen performed at a local hospital showed no abnormalities. MRI of the brain was performed after admission. One week after admission, she experienced a severe headache in the upper left periorbital area. The numbness extended to T4, and thermoception decreased below T4. Diagnosis: Lateral medullary infarction. Interventions: Anti-platelet aggregation and mitochondrial nutritional therapies were performed along with treatments for improving circulation and establishing collateral circulation. Outcomes: The intensity of limb numbness decreased, and the symptoms of headache and dizziness resolved. Conclusion: Lesions leading to segmental sensory disorders can occur in the medulla oblongata. Ipsilateral headaches with contralateral segmental paresthesia can be a specific sign of lateral medullary infarction.

scholarly journals Surgical Management of Intracranial Epidermoid Tumors—An Institutional Review of 234 Cases

2019 ◽  
Vol 08 (01) ◽  
pp. 025-033
Author(s):  
Vernon Velho ◽  
Anuj Bhide ◽  
Harish Naik ◽  
Nimesh Jain
Keyword(s):  
Management Strategies ◽  
Csf Leak ◽  
Western India ◽  
Total Excision ◽  
Total Resection ◽  
Complete Excision ◽  
Common Location ◽  
Adjacent Structures ◽  
Intracranial Epidermoid

Abstract Aim To study the demographics, clinical profile, management strategies, and treatment outcomes of intracranial epidermoid lesions. Materials and Methods A single institutional retrospective analysis from a large institute in Western India was done of all patients operated for intracranial epidermoid tumors over a period of 20 years from January 1997 to January 2017. All patients were investigated with a contrast-enhanced computed tomography (CECT) as well as a magnetic resonance imaging (MRI), with a diffusion-weighted imaging to confirm diagnosis of epidermoid tumor. The presenting complaints and the demographics of all patients were recorded, and all patients underwent planned surgery, with or without a cerebrospinal fluid (CSF) diversion procedure as per requirement. Surgery ranged from a gross total resection to a near-total resection depending on the patient, location of the lesion, and involvement of adjacent structures. All patients underwent an immediate postoperative computed tomographic (CT) scan as well as a follow-up MRI. Patients were followed up to note clinical improvement as well as documentation of all complications. Results Total 234 patients of intracranial epidermoid tumors were operated upon in a 20-year span. Males predominated with a total number of 146 (62.4%). The most common age group was the fourth decade. The most common presentations were headache (118 patients) and neuralgia in the trigeminal distribution (82 patients). Infratentorial compartment was the most common location of the tumors (152 patients), with cerebellopontine angle being the predominant site in the posterior fossa (107 patients). Both supra- and infratentorial compartments were involved in 28 cases. Gross total excision could be achieved in 202 patients. Reoperation was required in 12 cases. The mean follow-up period was 68 months. The most common complication encountered was that of postoperative CSF leak (24 patients). We had eight cases of recurrence and six deaths in our series. Conclusion Epidermoid tumors can arise in virtually all intracranial locations. Gross total excision of the tumor is treatment of choice and can be curative for these benign lesions. Large lesions at presentation with involvement of multiple compartments can be difficult to manage and may require bicompartmental or second look surgery. Complete excision of the capsule with preservation of adjacent neuronal and vascular structures is of utmost importance to decrease postoperative morbidity and chances of recurrence. Perioperative steroids, avoidance of intraoperative spillage, and intraoperative endoscopic assistance are recommended in all cases.

scholarly journals Hypertrophic olivary degeneration concomitant with bilateral middle cerebellar peduncles Wallerian degeneration following unilateral pontine infarction

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bing Bao ◽  
Xiangbin Wu ◽  
Zhongbin Xia ◽  
Yaoyao Shen
Keyword(s):  
Wallerian Degeneration ◽  
Corticospinal Tract ◽  
Brain Magnetic Resonance Imaging ◽  
Acute Onset ◽  
Case Presentation ◽  
Hypertrophic Olivary Degeneration ◽  
Pontine Infarction ◽  
Cerebellar Peduncles ◽  
Magnetic Resonance Imaging Mri

Abstract Background Wallerian degeneration (WD) can occur in different projecting systems, such as corticospinal tract, dentate-rubro-olivary pathway, and corticopontocerebellar tract. However, the co-occurrence of hypertrophic olivary degeneration (HOD) and middle cerebellar peduncles (MCPs) degeneration secondary to unilateral pontine infarction in a single patient is extremely rare. Case presentation A 71-year-old man presented with acute onset of dizzness, slurred speech, and right-sided weakness. On the next day, his previous neurologic deficits deteriorated. Brain magnetic resonance imaging (MRI) revealed acute ischemic stroke of the left pons. After treatment with thrombolysis, antiplatelets, and rehabilitation training, his speaking and motor function improved moderately. At the 3-month follow-up, the MRI showed hyperintensity in the left medulla oblongata and bilateral MCPs on T2-weighted and FLAIR images, suggesting HOD as well as MCPs degeneration. Conclusions It is of great importance for us to know the anatomic knowledge of dentate-rubro-olivary and corticopontocerebellar pathways.

scholarly journals Penetrating brain injury with a metal bar and a knife: Report of two interesting cases

2017 ◽  
Vol 31 (2) ◽  
pp. 203-206 ◽  
Author(s):  
Alireza Tabibkhooei ◽  
Morteza Taheri ◽  
Sadra Rohani ◽  
Iran Chanideh ◽  
Hessam Rahatlou
Keyword(s):  
Brain Injury ◽  
Surgical Intervention ◽  
Wide Spectrum ◽  
Good Health ◽  
Brain Parenchyma ◽  
Antibiotic Administration ◽  
Case Presentation ◽  
Penetrating Brain Injury ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Introduction Penetrating brain injury (PBI) is uncommon among the civilian population. Here, we report two interesting cases of PBI. Case presentation The first patient was a 20-year-old male who sustained a penetrating head injury with a metal bar during an accident at work. The patient underwent early surgical intervention, and related meningitis was treated with antibiotics. The patient was discharged 45 days later with no deficit. The second patient was a 34-year-old male who was the victim of a violence attack and was admitted to hospital. He was struck by a knife to his right temporal bone. A brain computed tomography scan and magnetic resonance imaging (MRI) demonstrated the tract of the knife within the brain parenchyma. The patient underwent conservative treatment. After several weeks, the patient was discharged in good health. Conclusion Although severe PBI has a poorer prognosis than a blunt brain injury, in treating of these patients, aggressive and timely surgical intervention, proper wide-spectrum antibiotic administration, stringent and diligent care in the intensive-care unit and careful management of the associated complications are mandated.

scholarly journals Scalp Metastasis of Cervical Cancer With Favorable Outcome

2020 ◽  
Vol 8 (3) ◽  
pp. 333-335
Author(s):  
Elham Saffarieh ◽  
Setare Nassiri ◽  
Maedeh Brahman ◽  
Soheila Amini Moghaddam ◽  
Shima Hosseini
Keyword(s):  
Cervical Cancer ◽  
Multidisciplinary Approach ◽  
Uterine Cervical Cancer ◽  
Radical Excision ◽  
Hematogenous Spread ◽  
Papilloma Virus ◽  
Case Presentation ◽  
Frontal Part ◽  
Scalp Metastasis

Introduction: Carcinoma of the uterine cervix is the most common gynecological malignancies in developing countries. Human papilloma virus is known as the main etiology. In addition, the spread of uterine cervical cancer often occurs through direct local extension and the lymphatics although the hematogenous spread is uncommon. Further, the scalp metastasis of cervical cancer is extremely rare. Case Presentation: In this regard, a 50-year-old woman with scalp metastasis of previous cervical cancer was discussed in the present study. She was suffering from a fast-growing and painful nodule, located on the frontal part of the scalp as a sole site of metastasis. A multidisciplinary approach was considered for her, which consisted of radical excision, followed by radiotherapy and chemotherapy. Given the lack of abundant evidence for the efficacy of this treatment, our patient has fortunately survived for more than two years. Conclusions: During the follow-up period after the completion of treatment, it is not sensible to only focus on the primary site of the tumor and thus entire examination is mandatory in this regard.

scholarly journals Progressive Intracranial Vertebral Artery Dissection Presenting with Isolated Trigeminal Neuralgia-Like Facial Pain

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Tomoki Nakamizo ◽  
Takashi Koide ◽  
Hiromichi Miyazaki
Keyword(s):  
Trigeminal Neuralgia ◽  
Vertebral Artery ◽  
Facial Pain ◽  
Brain Infarction ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Intracranial vertebral artery dissection (IVAD) is a potentially life-threatening disease, which usually presents with ischemic stroke or subarachnoid hemorrhage. IVAD presenting with isolated facial pain is rare, and no case with isolated trigeminal neuralgia- (TN-) like facial pain has been reported. Here, we report the case of a 57-year-old male with IVAD who presented with acute isolated TN-like facial pain that extended from his left cheek to his left forehead and auricle. He felt a brief stabbing pain when his face was touched in the territory of the first and second divisions of the left trigeminal nerve. There were no other neurological signs. Magnetic resonance imaging (MRI) of the brain 7 days after onset revealed dissection of the left intracranial vertebral artery without brain infarction. The pain gradually disappeared in approximately 6 weeks, and the patient remained asymptomatic thereafter, except for a brief episode of vertigo. Follow-up MRI revealed progressive narrowing of the artery without brain infarction. This case indicates that IVAD can present with isolated facial pain that mimics TN. IVAD should be considered in the differential diagnosis of acute facial pain or TN.

scholarly journals Anterior orbital leiomyoma originating from the supraorbital neurovascular bundle

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774099
Author(s):  
Selam Yekta Sendul ◽  
Cemile Ucgul Atilgan ◽  
Fevziye Kabukcuoglu ◽  
Semra Tiryaki Demir ◽  
Dilek Guven
Keyword(s):  
Differential Diagnosis ◽  
Dermoid Cyst ◽  
Female Patient ◽  
Excisional Biopsy ◽  
Young Female ◽  
Neurovascular Bundle ◽  
Upper Eyelid ◽  
Case Presentation ◽  
Orbital Tumour

Purpose: To present a young female patient with left anterior orbital leiomyoma that originates from the supraorbital neurovascular bundle. Case presentation: A 41-year-old female patient was admitted to our clinic with a complaint of swelling of the left upper eyelid. Based on the ophthalmological and imaging assessments, the excisional biopsy with the preliminary diagnosis of dermoid cyst was planned. The histopathological and immunohistochemical examinations of excised sample revealed surprisingly that the tumour was a leiomyoma. No recurrence was detected in the patient’s follow-up. Conclusion: Although it is rare, orbital leiomyoma should be considered in the differential diagnosis of patients with orbital tumour.

scholarly journals A Case Report of Primary Brain Hydatid Cyst in a Child

2020 ◽  
Vol 6 (1) ◽  
pp. 41-48
Author(s):  
Deepak Garg ◽  
◽  
Gaurav Jain ◽  
Virendra Sinha ◽  
◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Female Child ◽  
The Body ◽  
Body Parts ◽  
Resonance Imaging ◽  
Limb Weakness ◽  
Case Presentation ◽  
Clinical Presentations ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Background and Importance: Hydatid cyst is endemic in India, with different clinical presentations according to the site of involvement in the body. However, its occurrence in the brain without the involvement of other body parts is rare. Case Presentation: An eight-year-old female child presented with right-sided limb weakness and slurring of speech. The diagnosis of primary brain hydatid cyst was made with Magnetic Resonance Imaging (MRI) of the brain. The cyst was removed completely, resulting in improved post-operative slurring of speech and limb weakness. Conclusion: In countries where hydatid disease is endemic, brain hydatidosis should on top of the differential diagnoses for intracerebral cystic lesions and managed as per hydatid protocol until proved otherwise. This approach is critical to prevent rupture and dissemination.

scholarly journals Overlapping syndrome mimicking infectious meningoencephalitis in a patient with MOG and GFAP IgG

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suqiong Ji ◽  
Chenchen Liu ◽  
Zhuajin Bi ◽  
Huajie Gao ◽  
Jian Sun ◽  
...  
Keyword(s):  
White Matter ◽  
Oral Prednisolone ◽  
Pulse Therapy ◽  
Tuberculosis Treatment ◽  
Case Presentation ◽  
Steroid Pulse ◽  
Csf Analysis ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Background Central nervous system overlapping autoimmune syndromes are uncommon, especially with the coexistence of MOG-IgG and GFAP-IgG. Case presentation A 23-year-old woman presented with transient convulsions, a loss of consciousness, persistent fever, headache, and vomiting. Cerebrospinal fluid (CSF) analysis revealed elevated cellularity, and magnetic resonance imaging (MRI) showed diffuse leptomeningeal enhancement. She had fever and headache with antiviral and antibiotic treatment for 2 weeks, and she had empirical anti-tuberculosis treatment and oral prednisolone therapy. She was followed for 3 months after presentation with improved symptoms and normal CSF analysis. A 3-month follow-up MRI showed asymmetric lesions in the cerebellum, corona radiata, and white matter with enhancement. The anti-tuberculosis treatment was continued, and steroid therapy was discontinued. After she stopped taking prednisolone, an interrupted headache gradually appeared. MRI at 4 months after presentation revealed a partial reduction in lesions but enlarged areas in the left cerebellum and right parietal white matter and a new lesion in the region of the right ependyma with linear enhancement. Her CSF was positive for anti-myelin oligodendrocyte glycoprotein (MOG) and anti-glial fibrillary acidic protein (GFAP) antibodies using a transfected cell-based assay. She was diagnosed with overlapping syndrome of MOG‑IgG‑associated disease and GFAP astrocytopathy. She received steroid pulse therapy (methylprednisolone, 1 g for 5 days), followed by a gradual tapering of oral prednisolone and the addition of an immunosuppressant (tacrolimus, 3 mg per day). Six months after the initial presentation, she had no symptoms. An MRI showed that the lesions had diminished, and no enhancement was found. Conclusions We report a case that was positive for double antibodies, which was initially misdiagnosed as infectious meningoencephalitis. This case broadens the clinical and phenotypic presentation of the overlapping syndrome spectrum.

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