scholarly journals Axonal damage correlates with disability in patients with relapsing- remitting multiple sclerosis. Results of a longitudinal magnetic resonance spectroscopy study

Brain ◽  
1998 ◽  
Vol 121 (8) ◽  
pp. 1469-1477 ◽  
Author(s):  
N De Stefano
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Axonal Damage ◽  
Resonance Spectroscopy ◽  
Spectroscopy Study ◽  
Magnetic Resonance Spectroscopy Study ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

scholarly journals Diagnostic Dilemma: An Atypical Case of Astrocytoma in a Patient with Relapsing–Remitting Multiple Sclerosis

2021 ◽  
Vol 13 (2) ◽  
pp. 240-251
Author(s):  
Chantal Kahovec ◽  
Aman Saini ◽  
Michael C. Levin
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Brain Tumors ◽  
Resonance Spectroscopy ◽  
Low Grade ◽  
Relapsing Remitting ◽  
Mri Scans ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Progressive Course

Distinguishing between tumefactive demyelinating lesions (TDLs) and brain tumors in multiple sclerosis (MS) can be challenging. A progressive course is highly common with brain tumors in MS and no single neuroimaging technique is foolproof when distinguishing between the two. We report a case of a 41-year-old female with relapsing–remitting multiple sclerosis, who had a suspicious lesion within the left frontal hemisphere, without a progressive course. The patient experienced paresthesias primarily to her right hand but remained stable without any functional decline and new neurological symptoms over the four years she was followed. The lesion was followed with brain magnetic resonance imaging (MRI) scans, positron emission tomography–computed tomography scans, and magnetic resonance spectroscopy. Together, these scans favored the diagnosis of a TDL, but a low-grade tumor was difficult to rule out. Examination of serial brain MRI scans showed an enlarging lesion in the left middle frontal gyrus involving the deep white matter. Neurosurgery was consulted and an elective left frontal awake craniotomy was performed. Histopathology revealed a grade II astrocytoma. This case emphasizes the importance of thorough and continuous evaluation of atypical MRI lesions in MS and contributes important features to the literature for timely diagnosis and treatment of similar cases.

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