Giant cavernous angioma of the temporal lobe: a case report and review of the literature

2005 ◽  
Vol 46 (3) ◽  
pp. 310-313 ◽  
Author(s):  
F. Gelal ◽  
H. Feran ◽  
T. Rezanko ◽  
B. Dİrİm Vİdİnlİ
Keyword(s):  
Temporal Lobe ◽  
Degradation Products ◽  
Correct Diagnosis ◽  
Cavernous Angioma ◽  
Mass Effect ◽  
Vascular Lesions ◽  
Mri Findings ◽  
Cavernous Angiomas ◽  
Imaging Appearance ◽  
Magnetic Resonance Imaging Mri

Cavernous angiomas of the central nervous system are angiographically occult vascular lesions and are easily diagnosed by magnetic resonance imaging (MRI). Giant cavernous angiomas (GCA) are rare, with only 11 cases reported in the literature. Imaging appearance of GCAs has not been reviewed previously. We report a GCA of the temporal lobe, and discuss its computed tomography and MRI findings in the view of the literature. Imaging appearance of GCAs is variable. Some GCAs have features that are similar to those of typical cavernous angiomas, whereas some lesions may be purely cystic; and some present with significant contrast enhancement and mass effect, mimicking neoplasms. While the presence of hemosiderin, blood degradation products, and calcification may be helpful in the diagnosis of some cases, the correct diagnosis is not apparent until histopathological evaluation of the specimen is made in many instances.

scholarly journals Rapidly progressive dementia due to neurosarcoidosis

2013 ◽  
Vol 7 (4) ◽  
pp. 428-434
Author(s):  
Gabriela Carneiro C. Fortes ◽  
Marcos Castello B. Oliveira ◽  
Laura Cardia G. Lopes ◽  
Camila S. Tomikawa ◽  
Leandro T. Lucato ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Oral Prednisone ◽  
Brain Biopsy ◽  
High Dose ◽  
Mri Findings ◽  
Progressive Dementia ◽  
Granulomatous Angiitis ◽  
Severe Impairment ◽  
Magnetic Resonance Imaging Mri ◽  
One Year

ABSTRACT Rapidly progressive dementia (RPD) is typically defined as a cognitive decline progressing to severe impairment in less than 1-2 years, typically within weeks or months. Accurate and prompt diagnosis is important because many conditions causing RPD are treatable. Neurosarcoidosis is often cited as an unusual reversible cause of RPD. Methods: We report two cases of neurosarcoidosis presenting as RPD. Results: Case 1: A 61-year-old woman developed a RPD associated with visual loss. In seven months she was dependent for self-care. Magnetic resonance imaging (MRI) revealed temporal and suprasellar brain lesions. Treatment with high-dose intravenous prednisolone was associated with partial improvement. Case 2: A 43-year-old woman who was being treated for diabetes insipidus developed a severe episodic amnesia one year after onset of cognitive symptoms. Previous MRI had shown a hypothalamic lesion and she had been treated with oral prednisone and cyclophosphamide. There was reduction of the MRI findings but no improvement in the cognitive deficits. Brain biopsy disclosed noncaseous granulomas and granulomatous angiitis; treatment was changed to high-dose intravenous methylprednisolone, with poor symptomatic response. Conclusion: The diagnosis of RPD due to neurosarcoidosis can be challenging when the disease is restricted to the nervous system. In these cases, clinical presentation of RPD associated with neuroendocrine and visual dysfunction, imaging findings showing hypothalamic lesions and, in some cases, brain biopsy, are the key to a correct diagnosis. It is possible that earlier diagnoses and treatment could have led to a better outcome in these patients.

scholarly journals Brainstem Encephalitis Caused by Listeria monocytogenes

Pathogens ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 715
Author(s):  
Pengxu Wei ◽  
Ruixue Bao ◽  
Yubo Fan
Keyword(s):  
Listeria Monocytogenes ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Good Health ◽  
Enteric Neurons ◽  
Brainstem Encephalitis ◽  
Mri Findings ◽  
Periodontal Tissues ◽  
Magnetic Resonance Imaging Mri

International outbreaks of listerial infections have become more frequent in recent years. Listeria monocytogenes, which usually contaminates food, can cause potentially fatal infections. Listerial cerebritis is a rare disease that is encountered mostly in immunocompromised or elderly patients. However, listerial brainstem encephalitis (mesenrhombencephalitis or rhombencephalitis) is found in persons who were formerly in good health, and recognizing this disease, particularly at its early stages, is challenging. Listerial brainstem encephalitis has high mortality, and serious sequelae are frequently reported in survivors. Early recognition and correct diagnosis, as well as the timely use of appropriate antibiotics, can reduce the severity of listerial infections. The trigeminal nerve is proposed as a pathway through which L. monocytogenes reaches the brainstem after entering damaged oropharyngeal mucosa or periodontal tissues. This review introduces the clinical manifestations, pathology, magnetic resonance imaging (MRI) findings, diagnosis, and treatment of listerial brainstem encephalitis. Moreover, it proposes that L. monocytogenes may also invade the brainstem along the vagus nerve after it infects enteric neurons in the walls of the gastrointestinal tract.

scholarly journals Rare case of giant pediatric cavernous angioma of the temporal lobe: A case report and review of the literature

2020 ◽  
Vol 11 ◽  
pp. 7
Author(s):  
Fahd Derkaoui Hassani ◽  
Claire Karekezi ◽  
Najia El Abbadi
Keyword(s):  
Temporal Lobe ◽  
Cavernous Angioma ◽  
Mass Effect ◽  
Cavernous Malformations ◽  
Perilesional Edema ◽  
The Central Nervous System ◽  
The Brain ◽  
Underlying Pathology ◽  
Significant Mass Effect ◽  
Significant Mass

Background: Giant cavernous malformations of the central nervous system are quite rare. They are more common in children and may be misdiagnosed as other intracranial neoplasms. Here, we presented a very rare giant cavernous angioma mimicking a neoplastic temporal lobe lesion in an 18-month-old male. Case Description: An 18-month-old male presented with two initial seizures. Although the clinical examination was normal, the computed tomography (CT) scan showed a large left temporal mass (66 mm diameter) exerting significant mass effect and midline shift. The brain magnetic resonance (MR) imaging demonstrated a large left temporal heterogeneously enhancing lesion with significant perilesional edema and mass effect. The patient underwent gross total removal of the lesion that proved to be an intracranial cavernous angioma. Postoperatively, he did well, exhibiting no residual neurological deficit, and has remained lesion and seizure-free. Conclusion: This and 12 other cases in the literature focus on intracranial cavernous angiomas that could have been readily misdiagnosed as tumors. It confirms why obtaining appropriate preoperative MR and CT studies, followed by surgical intervention, is essential to confirm the correct underlying pathology and appropriately and optimally treat the patient.

scholarly journals Perivascular Spaces: Normal and Giant

2007 ◽  
Vol 34 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Randy Fanous ◽  
Mehran Midia
Keyword(s):  
Contrast Material ◽  
Mass Effect ◽  
Brain Parenchyma ◽  
Perivascular Spaces ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Anatomy And Physiology ◽  
Mri Sequences ◽  
Magnetic Resonance Imaging Mri ◽  
Adjacent Brain

The purpose of this paper is to discuss both normal perivascular spaces (PVSs) and pathological giant perivascular spaces (GPVSs). The anatomy and physiology of normal PVSs, including important immunological and lymphatic roles, are described. Special attention is given to the Magnetic Resonance Imaging (MRI) findings of both normal and GPVSs. Furthermore, the clinical features and pathogenesis of GPVSs are explored, with special emphasis on the pathological implications of these lesions, and their relevance. It is important that symptomatic GPVSs not be mistaken for more devastating disease processes. When the lesions in question occur in a characteristic location along the path of a penetrating vessel, are isointense with cerebrospinal fluid on all MRI sequences, do not enhance with contrast material, are not calcified, and have normal adjacent brain parenchyma, their appearance is pathognomonic of GPVSs. The clinician should realize that an extensive differential diagnosis is superfluous and that biopsy is unnecessary in these patients. Instead, the clinical focus should be aimed at neurosurgical intervention, as dictated by the symptoms of mass effect.

Severe global amnesia presenting as Wernicke–Korsakoff syndrome but resulting from atypical lesions

1996 ◽  
Vol 26 (2) ◽  
pp. 421-425 ◽  
Author(s):  
L. W. Welch ◽  
A. Nimmerrichter ◽  
R. Kessler ◽  
D. King ◽  
R. Hoehn ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Mri Findings ◽  
Dorsal Thalamus ◽  
Mammillary Bodies ◽  
Positron Emission ◽  
Korsakoff Syndrome ◽  
Global Amnesia ◽  
Magnetic Resonance Imaging Mri ◽  
Korsakoffs Syndrome ◽  
The Right

SynopsisA female alcoholic presented with Wernicke's encephalopathy subsequent to administration of diazepam and glucose (without thiamine) for treatment of withdrawal seizures. Nystagmus and cerebellar ataxia quickly resolved when administered thiamine, although severe global amnesia consistent with Korsakoffs syndrome persisted. Magnetic resonance imaging (MRI) revealed infarction of the right temporal lobe with hippocampal atrophy, but no lesions of thalamus or atrophy of mammillary bodies. Positron emission tomography (PET) confirmed decreased cerebral metabolic rates for glucose (CMRglu) in the right temporal lobe corresponding to MRI findings, but also significant metabolic asymmetry of dorsal thalamus, i.e reduced CMRglu in left versus right. This patient is unique in that neuroradiological findings revealed intact mammillary bodies and suggest asymmetrical dysfunctions (structural right temporal and functional left diencephalic) to produce her profound amnesia.

scholarly journals Magnetic Resonance Imaging of Bacterial Meningoencephalitis in a Foal

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Judit Viu ◽  
Lara Armengou ◽  
Cristian de la Fuente ◽  
Carla Cesarini ◽  
Sònia Añor ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Mri ◽  
Mass Effect ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cortical Areas ◽  
Fluid Analysis ◽  
Mri Features ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI) in equidae suffering meningoencephalitis (ME) has not been described. The objective of this paper is to describe brain MRI findings in a foal with bacterial ME. A five-month-old, 200 kg bwt Arabian filly was referred with a history of abnormal mental status and locomotion. The filly was recumbent and obtunded, and pupillary light reflexes were sluggish, and oculocephalic movements were normally present. Ophthalmic examination revealed bilateral optic neuritis. Hematology revealed leukocytosis and neutrophilia. Cerebrospinal fluid analysis showed neutrophilic pleocytosis with intracellular bacteria. On brain MRI, there were multifocal cortical areas of mild hyperintensity on T2-weighted images (T2WI) affecting both hemispheres. The lesions had ill-delineated margins, and there was loss of differentiation between gray and white matter. Diffuse hyperintensity was also identified in the left cerebellar cortex on T2WI. Neither mass effect nor cerebral midline shift were identified. On FLAIR images, the lesions were also hyperintense and, in some areas, they seemed to coalescence to form diffuse cortical areas of hyperintensity. The MRI findings described were similar to the MRI features described in cases of humans and small animals with ME. Brain MRI can be a useful diagnostic tool in foals and small-sized equidae with intracranial disease.

scholarly journals Diagnostic Accuracy of Preoperative Conventional MRI for Patients With Ectopic Pregnancy

2021 ◽  
Vol 105 (1-3) ◽  
pp. 449-454
Author(s):  
Toshimichi Onuma ◽  
Kimihisa Tajima ◽  
Kumiko Sato ◽  
Katsushige Hattori ◽  
Shin Fukuda ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Predictive Value ◽  
Correct Diagnosis ◽  
Tubal Pregnancy ◽  
Mri Findings ◽  
Tubal Ectopic Pregnancy ◽  
Conventional Mri ◽  
Mri Diagnosis ◽  
Preoperative Magnetic Resonance ◽  
Magnetic Resonance Imaging Mri

Objective To assess the utility of preoperative magnetic resonance imaging (MRI) in the diagnosis of tubal pregnancy. Summary of background data Most cases of ectopic pregnancy are tubal pregnancies. Preoperative accurate diagnosis including the location of the tubal pregnancy is important. Method We performed a retrospective single-center cohort study evaluating patients who underwent surgery for ectopic pregnancy from April 2004 to March 2016 and who underwent preoperative MRI. Sixty patients were enrolled in the study. Chorion confirmed at the tubal pregnancy site detected by MRI was defined as a correct diagnosis. Results Mean estimated gestational age at the time of MRI according to the last menstrual period was 7 weeks (median: 5 weeks; range: 3–10 weeks). Ectopic pregnancy was diagnosed by MRI in 57 cases, and all cases were either left or right tubal pregnancy. In 52 cases, the actual position matched the MRI findings. In 5 cases, the location of tubal ectopic pregnancy was different from that diagnosed by MRI, or no tubal pregnancy was observed intraoperatively. In 2 cases, no ectopic pregnancy site was observed on MRI, but tubal pregnancy was confirmed by surgery. In one case, an ectopic pregnancy site was not found, and the tube showed normal findings on MRI. The sensitivity of MRI diagnosis was 96.2%, specificity was 16.7%, positive predictive value was 91.1%, and negative predictive value was 33.3%. Conclusion In cases of ectopic pregnancy treated surgically, the sensitivity of MRI diagnosis, including identification of the location of ectopic pregnancy, is high.

Meckel–Gruber Syndrome: Correlation between Ultrasound and Magnetic Resonance Assessment in a Fetal Case with Severe Oligohydramnios

2020 ◽  
Author(s):  
Paulo R. S. F. de Almeida ◽  
Sandra F. Centofanti ◽  
Rafael L. do Carmo ◽  
Bruno S. Y. Inada ◽  
Victor H. R. Marussi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Autosomal Recessive ◽  
Correct Diagnosis ◽  
Recessive Mutation ◽  
Genetic Condition ◽  
Mri Findings ◽  
Cystic Kidneys ◽  
Autosomal Recessive Mutation ◽  
Antenatal Ultrasonography ◽  
Magnetic Resonance Imaging Mri

AbstractMeckel–Gruber syndrome (MGS) is a rare genetic condition determined by an autosomal recessive mutation and characterized by occipital cephalocele, postaxial polydactyly, and bilateral dysplastic cystic kidneys, besides many other findings. Antenatal ultrasonography can identify the major features, but in selected cases, magnetic resonance imaging (MRI) might help to obtain the correct diagnosis. We describe a well-documented case of MGS diagnosed by ultrasound in correlation with MRI findings.

The Pathogenesis of Thrombotic Thrombocytopenic Purpura

1979 ◽  
Author(s):  
H. C. Kwaan
Keyword(s):  
Plasminogen Activator ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Degradation Products ◽  
Vascular Lesions ◽  
Local Defect ◽  
Laboratory Findings ◽  
Thrombocytopenic Purpura ◽  
Fibrin Degradation Products ◽  
Severity Of The Disease ◽  
Circulating Levels

The vascular lesions with microthrombi were studied in 12 patients with thrombotic thrombocytopenic purpura (TTP), diagnosed by the characteristic clinical and laboratory findings and confirmed histologically in each case. While defibrination was not observed, and with only minimal changes in the circulating levels of fibrinogen, fibrin degradation products and plasminogen activator, the microthrombotic lesion was invariably present. Immunofluorescent and histochemical studies indicated that both platelet and fibrin were present in the microthrombi with the platelet components dominant in many cases. Using the fibrin slide method, plasminogen activator was demonstrated in the uninvolved blood vessels but totally absent in the vessels occluded by microthrombi. in contrast, fibrinolysis is always present in the vessels afflicted with other types of thrombosis, such as the microthrombi in disseminated intravascular coagulation. Since circulating fibrinolytic activity was normal in TTP, the absence of vascular fibrinolysis is a local defect due to either inhibition by the platelet deposits or by local vascular damage. The inability of thrombolysis may explain the absence of systemic defibrination and the severity of the disease.

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

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