Cerebral Epidural Abscess Secondary to Blastomyces Masquerading as an Epidermoid Tumor

Abstract There have been infrequent reports of isolated central nervous system blastomycosis. We report a case of intracranial epidural abscess secondary to Blastomyces dermatitidis in a patient residing in Rhode Island with a history of remote travel to an endemic area. The clinical, radiographic, and pathologic features of this unique case are reviewed.

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Acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) associated with choroidal melanoma

International Journal of Retina and Vitreous ◽

10.1186/s40942-021-00300-0 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Aluisio Rosa Gameiro Filho ◽

Guilherme Sturzeneker ◽

Ever Ernesto Caso Rodriguez ◽

André Maia ◽

Melina Correia Morales ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Serous Retinal Detachment ◽

Central Nervous System Involvement ◽

Choroidal Melanoma ◽

Posterior Pole ◽

Pancreatic Metastasis ◽

Small Areas ◽

History Of ◽

The Right

Abstract Background To report a case of acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with a history of choroidal melanoma, with metastases to the pancreas, liver, and central nervous system. Case presentation A 63-year-old patient, with a history of enucleation of the right eye due to choroidal melanoma, complained of progressive visual loss during a follow-up visit. Fundoscopic examination revealed multiple small areas of serous retinal detachment scattered throughout the posterior pole and ancillary tests confirmed the diagnosis of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM). Screening for systemic metastases showed pancreatic, hepatic, and central nervous system involvement. Conclusions We describe a rare case of acute exudative polymorphous paraneoplastic vitelliform maculopathy, which should be considered in patients with or without a history of melanoma, who have vitelliform retinal detachments. Nevertheless, no previous reviews of literature have shown a correlation between AEPPVM and pancreatic metastasis.

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Natural history of central nervous system acute leukemia in adults

Cancer ◽

10.1002/1097-0142(19810101)47:1<184::aid-cncr2820470130>3.0.co;2-m ◽

1981 ◽

Vol 47 (1) ◽

pp. 184-196 ◽

Cited By ~ 89

Author(s):

David J. Stewart ◽

Michael J. Keating ◽

Kenneth B. McCredie ◽

Terry L. Smith ◽

Eshan Youness ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Natural History ◽

Acute Leukemia ◽

History Of

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ACUTE POISONING ASSOCIATED WITH INHALATION OF MERCURY VAPOR

PEDIATRICS ◽

10.1542/peds.22.4.675 ◽

1958 ◽

Vol 22 (4) ◽

pp. 675-688

Author(s):

Fred T. Matthes ◽

Rudolph Kirschner ◽

Martha D. Yow ◽

James C. Brennan

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Interstitial Pneumonitis ◽

Laboratory Tests ◽

Mercury Vapor ◽

Acute Poisoning ◽

Mercury Content ◽

Sudden Onset ◽

Pathologic Features ◽

Early Use

Four cases of pneumonitis associated with the inhalation of mercury vapor are described in detail. Three of the four cases were fatal. The illness was characterized by the sudden onset of tachypnea, cough, fever, gastrointestinal disturbances and central nervous system manifestations. Ordinary laboratory tests were not helpful in establishing the diagnosis. Quantitative analysis of the urine for mercury was suggestive but not diagnostic. Roentgenograms of the lungs revealed interstitial pneumonitis. Analysis of tissue for mercury in the lungs, liver and spleen of two of the cases showed substantially increased mercury content. The outstanding pathologic features in the three fatal cases were erosive bronchitis and bronchiolitis, with severe interstitial pneumonitis. The presently accepted mode of therapy for acute poisoning due to ingestion of mercury is early use of BAL. Its use is probably also indicated in acute poisoning due to inhalation of mercury vapor. Supportive care in the form of oxygen, mist, and parenteral fluids is indicated.

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THE FAMILY HISTORY OF SPINA BIFIDA CYSTICA

PEDIATRICS ◽

10.1542/peds.35.4.589 ◽

1965 ◽

Vol 35 (4) ◽

pp. 589-595

Author(s):

John Lorber

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Spina Bifida ◽

Index Case ◽

Progressive Increase ◽

Point Of View ◽

The Family ◽

History Of ◽

The Central Nervous System ◽

Spina Bifida Cystica

1. The family histories of 722 infants who were born with spina bifida cystica were studied. 2. The index cases were referred for surgical treatment and were not selected in any way from the genetic point of view. 3. Intensive inquiries were made to obtain a complete family pedigree, including a prospective follow-up of siblings born after the index case. 4. Of 1,256 siblings 85 or 6.8% had gross malformation of the central nervous system: spina bifida cystica in 54, anencephaly in 22, and uncomplicated hydrocephalus in 9. 5. Of 306 children born after the index case 25 (8%) or 1 in 12 were affected. 6. There was a progressive increase in multiple cases in the family with increasing family size. In sibships of five or more, multiple cases occurred in 24.1%. 7. In 118 families cases of gross malformation of the central nervous system were known to have occurred among members of the family other than siblings. Cases occurred in three generations. 8. It is possible that spina bifida cystica might be a recessively inherited condition.

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The life history of Hepatozoon leptodactyli (Lesage, 1908) Pessoa, 1970: a parasite of the common laboratory animal: the frog of the genus Leptodactylus

Memórias do Instituto Oswaldo Cruz ◽

10.1590/s0074-02761973000100001 ◽

1973 ◽

Vol 71 (1-2) ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Sylvio Celso Goncalves da Costa ◽

Samuel B. Pessoa ◽

Neize de Moura Pereira ◽

Tania Colombo

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Life History ◽

Laboratory Animal ◽

Peripheral Circulation ◽

Experimental Conditions ◽

History Of ◽

The Central Nervous System ◽

The Common ◽

Common Laboratory

The main object of the present paper is to furnish a brief account to the knowledgement of Protozoa parasitic in common Brazilian frog of the genus Leptodactylus for general students in Zoology and for investigators that use this frog as a laboratory animal. Hepatozoon leptodactyli (Haemogregarina leptodactyli) was found in two species of frogs - Leptodactylus ocellatus and L. pentadactylus - in which develop schizogony whereas sporogony occurs in the leech Haementeria lutzi as was obtainded in experimental conditions. Intracellular forms have been found in peripheral circulation, chiefly in erythrocytes, but we have found them in leukocytes too. Tissue stages were found in frog, liver, lungs, spleen, gut, brain and heart. The occurence of hemogregarine in the Central Nervous System was recorded by Costa & al,(13) and Ball (2). Some cytochemical methods were employed in attempt to differentiate gametocytes from trophozoites in the peripheral blood and to characterize the cystic membrane as well. The speorogonic cycle was developed in only one specie of leech. A brief description of the parasite is given.

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Primary Hemangioblastoma of Kidney with Molecular Analyses by Next Generation Sequencing: A Case Report and Review of the Literature

10.21203/rs.3.rs-965157/v1 ◽

2021 ◽

Author(s):

Xintong Wang ◽

George K Haines ◽

Jane Houldsworth ◽

Qiusheng Si

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Renal Cell ◽

Pathological Examination ◽

Molecular Evidence ◽

Pathologic Features ◽

Eosinophilic Cytoplasm ◽

The Central Nervous System ◽

Positive Immunostaining ◽

Vhl Disease

Abstract Background: Hemangioblastoma is an indolent mesenchymal tumor most frequently occurring in the central nervous system (CNS), but can also arise extraneuraxially, as part of von Hippel-Lindau (VHL) disease or in sporadic cases. Extraneuraxial hemangioblastomas (EH) occur outside the central nervous system. It includes tumors arising from the nervous paraneuraxial structures and visceral organs. Sporadic hemangioblastoma of the kidney, a rare subset of EH, is an under-recognized renal neoplasm. There have been only 25 cases described to date in the English language literature. We report herein one additional case in a patient without VHL disease.Case presentation: A 61 year old male presenting with gross hematuria was found to have a 3.5 cm renal mass at the lateral mid to lower pole of the left kidney on computed tomography urogram. Patient underwent a partial nephrectomy for the mass. The pathological examination showed a well-circumscribed non-encapsulated tumor composed of sheets of large polygonal cells traversed by a rich vascular network. The tumor cells showed clear to eosinophilic cytoplasm and overall bland nuclei. The diagnosis of hemangioblastoma was confirmed by positive immunostaining for alpha-inhibin, S100, neuron-specific enolase, PAX8, and negative staining for epithelial membrane antigen, HMB-45, and Melan-A. VHL gene mutation was not detected in this tumor. The diagnosis of sporadic renal hemangioblastoma was made.Conclusion: Sporadic renal hemangioblastoma (RH) is a rare subset of EH. We report herein one such case in a patient without clinical or molecular evidence of VHL disease. We reviewed the literature to better understand the clinical, radiological and pathologic features of this neoplasm. From our review cases and the present case, we have found that the majority of RHs showed a positive immunostaining for PAX8, which supports the idea that the immunoprofiles of EH can vary depending on sites of origin. Diagnosis of renal hemangioblastoma is challenging because of its rarity and overlapping microscopic and immunophenotypic features with renal cell tumor, especially with clear cell renal cell carcinoma. However, accurate diagnosis is necessary, since RH is clinically benign and correct recognition of this pathological entity is important to avoid unnecessary over treatment.

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Brain and Spinal Abscesses

10.2310/im.1304 ◽

2017 ◽

Author(s):

Allan R Tunkel ◽

W Michael Scheld

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Brain Abscess ◽

Antimicrobial Therapy ◽

Epidural Abscess ◽

Clinical Manifestations ◽

Spinal Epidural Abscess ◽

Diffusion Weighted Images ◽

Optimal Approach ◽

Spinal Cord Dysfunction

Brain and spinal abscesses are focal infections of the central nervous system that are often associated with significant morbidity and mortality if not recognized early and managed in a timely manner. In patients with brain abscess, the clinical manifestations run the gamut from indolent to fulminant; most are related to the size and location of the space-occupying lesion within the brain and the virulence of the infecting organism. Untreated spinal epidural abscess usually progresses through four stages: backache and focal vertebral pain, nerve root pain, spinal cord dysfunction, and complete paralysis. Magnetic resonance imaging is the diagnostic neuroimaging procedure of choice in patients with brain and spinal abscesses; on diffusion-weighted images, restricted diffusion may be seen and may help distinguish abscesses from necrotic neoplasms. Aspiration of the abscess is important to facilitate microbiologic diagnosis; after aspiration and submission of specimens for special stains, histopathologic examination, and culture, empirical antimicrobial therapy should be initiated based on stains of the aspirated specimen and the probable pathogenesis of infection. Once the infecting pathogen is isolated, antimicrobial therapy can be modified for optimal treatment. Surgical therapy is often required for the optimal approach to patients with brain and spinal abscesses. This review contains 6 figures, 5 tables, and 72 references. Key words: antimicrobial therapy for central nervous system infections, brain abscess, epidural abscess, focal intracranial infections, head trauma, infections in immunocompromised hosts, spine infections, subdural empyema, toxoplasmosis

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Venous Thromboembolism Prophylaxis with Low-Molecular-Weight Heparin in Primary Central Nervous System Lymphoma

Oncology Research and Treatment ◽

10.1159/000512241 ◽

2020 ◽

pp. 1-6

Author(s):

Stav Gazal ◽

Eyal Lebel ◽

Yosef Kalish ◽

Chen Makranz ◽

Moshe E. Gatt ◽

...

Keyword(s):

Molecular Weight ◽

Central Nervous System ◽

Nervous System ◽

Venous Thromboembolism ◽

Low Molecular Weight Heparin ◽

Bleeding Event ◽

Central Nervous System Lymphoma ◽

B Cell Lymphoma ◽

Low Molecular Weight ◽

History Of

Background: Venous thromboembolism (VTE) is a frequent, potentially lethal complication in individuals with cancer. Patients with brain tumors are at particularly high risk for VTE. Primary central nervous system lymphoma (PCNSL) is a rare subtype of diffuse large B cell lymphoma, involving the craniospinal axis. The incidence of VTE in patients with PCNSL was reported as very high, occurring mostly in the early period of therapy. Objectives: We aimed to evaluate the efficacy and safety of prophylactic low-molecular-weight heparin (LMWH) throughout the treatment of PCNSL. Patients: All patients >18 years of age diagnosed and treated for PCNSL at our institution in 2005–2017 were included. Results: There were 44 patients; mean age at diagnosis was 61.5 years. Three patients (6.8%) had a personal history of thrombosis, 11 (25%) had a history of diabetes or smoking, and 32 (72%) had an Eastern Cooperative Oncology Group performance status of 0–1 at diagnosis. During treatment with LMWH, no VTE events were recorded; 2 (4.5%) patients experienced a minor bleeding event and 1 (2.3%) a major bleeding event. Conclusions: Among our 44 patients with PCNSL treated with prophylactic LMWH, no VTE events were recorded, and only 1 (asymptomatic) intracranial bleed was recorded. Within the limitations of a retrospective nonrandomized study, our findings suggest that VTE prophylaxis may be beneficial for individuals with PCNSL.

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Ecstasy-Associated Pneumomediastinum

Annals of The Royal College of Surgeons of England ◽

10.1308/003588407x183373 ◽

2007 ◽

Vol 89 (4) ◽

pp. 389-393 ◽

Cited By ~ 19

Author(s):

Silvana F Marasco ◽

H Kiat Lim

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Young Adults ◽

Inner City ◽

Physical Exertion ◽

Pharmacological Effect ◽

Valsalva Manoeuvre ◽

The Hours ◽

History Of ◽

The Central Nervous System

INTRODUCTION Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to its stimulant activity in the central nervous system. PATIENTS AND METHODS A database review at two major inner city hospitals was undertaken to identify patients presenting with pneumomediastinum and their charts reviewed. A Medline review of all reported cases of pneumomediastinum associated with ecstasy abuse was undertaken. RESULTS A total of 56 patients presenting with pneumomediastinum were identified over a 5-year period. Review of the charts revealed a history of ecstasy use in the hours prior to presentation in six of these patients, representing the largest series reported to date. CONCLUSIONS Review of previously reported cases reveals the likely mechanism is due to Valsalva manoeuvre during periods of extreme physical exertion, and not a direct pharmacological effect of the drug.

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Unilateral Neuroimaging Findings in Pediatric Craniofacial Scleroderma: Parry-Romberg Syndrome and En Coup de Sabre

Journal of Child Neurology ◽

10.1177/0883073820931253 ◽

2020 ◽

Vol 35 (11) ◽

pp. 753-762

Author(s):

Ronald R. Seese ◽

Daniel Glaser ◽

Andre Furtado ◽

Kavita Thakkar ◽

Kathryn S. Torok

Keyword(s):

Central Nervous System ◽

Nervous System ◽

White Matter ◽

Neurological Symptoms ◽

Localized Scleroderma ◽

Imaging Findings ◽

History Of ◽

Parry Romberg Syndrome ◽

Clinical Associations

Objective: Parry-Romberg syndrome (PRS) and en coup de sabre (ECDS) are subtypes of craniofacial localized scleroderma. Systematic analyses of central nervous system imaging findings and their clinical associations in children are lacking. Here, we aim to characterize neuroimaging findings and associated neurological symptoms in these conditions. Methods: Neuroimaging and neurological symptoms of children evaluated at our institution with a diagnosis of PRS or ECDS were retrospectively reviewed. Laterality, location, stability, and number of lesion(s) were evaluated, as was the presence of susceptibility lesion(s) and contrast enhancement. History of seizures or headaches was noted. Results: From 2003 to 2019, 80 patients with PRS or ECDS were followed at our institution. Neuroimaging was completed in 73 and found to be abnormal in 25. In 12 (48%) of these 25 cases, headaches and/or seizures were present. In the vast majority of these cases (22/25, 88%), lesions were ipsilateral to skin findings. White matter was involved in 19 (76%) patients. MRI abnormalities preceded a rheumatological diagnosis in 7 (28%). Susceptibility lesions were noted in 11 (44%), and 8 (73%) of these patients endorsed a history of headaches. Most lesions were in the supratentorial compartment, did not enhance, and were stable at 1-year follow up imaging. Of those with progression, susceptibility findings were present at baseline. Conclusions: Neuroimaging findings in pediatric PRS and ECDS are often supratentorial, stable, unilateral, and ipsilateral to skin findings, and they can precede cutaneous findings.

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