A Neurocytoma and an Associated Lenticulostriate Artery Aneurysm Presenting with Intraventricular Hemorrhage: Case Report

Neurosurgery ◽  
2001 ◽  
Vol 49 (3) ◽  
pp. 721-725 ◽  
Author(s):  
G. Edward Vates ◽  
Kelly A. Arthur ◽  
Steven G. Ojemann ◽  
Fred Williams ◽  
Michael T. Lawton
Keyword(s):  
Intraventricular Hemorrhage ◽  
Clinical Presentation ◽  
Artery Aneurysm ◽  
Central Neurocytoma ◽  
Fusiform Aneurysm ◽  
Resonance Imaging ◽  
Pathological Review ◽  
Lenticulostriate Artery ◽  
Intraventricular Neurocytoma ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE Hemorrhage associated with central neurocytoma has been described previously, but never in association with an aneurysm originating from a feeding artery. We present the first reported case of a central neurocytoma in a patient with intraventricular hemorrhage caused by rupture of an aneurysm on a lenticulostriate artery that supplied the tumor. CLINICAL PRESENTATION A 35-year-old man who presented with an intraventricular hemorrhage underwent magnetic resonance imaging and cerebral angiography that disclosed a right lateral intraventricular mass and a 7-mm fusiform aneurysm from a lateral lenticulostriate branch of the right middle cerebral artery. INTERVENTION The patient underwent a contralateral transcallosal exploration and resection of the tumor, with excision of the adjacent lenticulostriate artery aneurysm. Pathological review demonstrated that the tumor was a neurocytoma. The aneurysm was discrete from the tumor but occurred on a vessel that supplied the tumor. CONCLUSION Previous reports have demonstrated that intraventricular neurocytoma may present with tumor hemorrhage. In this case, an aneurysm separate and distinct from the tumor was the bleeding culprit, and the aneurysm was on an artery that fed into the tumor. Any such aneurysm must be identified and treated appropriately for therapy to be complete.

scholarly journals Stereotactic Body Radiotherapy of a Solitary Metachronous Sphenoid Metastasis from Renal Cell Cancer: A Case Report

2021 ◽  
pp. 269-273
Author(s):  
Charles Marchand Crety ◽  
Estelle Vigneau ◽  
Camille Invernizzi
Keyword(s):  
Renal Cell Cancer ◽  
Renal Cell ◽  
Stereotactic Body Radiation Therapy ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Cell Cancer ◽  
Papillary Renal Cell Carcinoma ◽  
Complete Response ◽  
Resonance Imaging ◽  
The Right

Nasosinus metastases from kidney cancer are an unusual clinical presentation although some cases are reported in the literature. Among these cases, sphenoidal metastases are even rarer. Here we report a case of lone sphenoid metastasis in patients with papillary renal cell cancer. Eight months after radical nephrectomy, the patient presented with progressively worsening diplopia. Magnetic resonance imaging showed a mass in the right sphenoid sinus. Histopathological examination of the biopsy sample confirmed diagnosis of sinonasal metastasis from papillary renal cell carcinoma. The patient was declined for surgical management and received stereotactic body radiation therapy. Reassessment MRI at 4 months showed a complete response of the treated sphenoid lesion.

scholarly journals Fusiform Lenticulostriate Artery Aneurysm with Subarachnoid Hemorrhage: The Role for Superselective Angiography in Treatment Planning

2010 ◽  
Vol 16 (3) ◽  
pp. 259-263 ◽  
Author(s):  
P.S. Kochar ◽  
W.F. Morrish ◽  
M.E. Hudon ◽  
J.H. Wong ◽  
M. Goyal
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Treatment Planning ◽  
Artery Aneurysm ◽  
Cerebral Angiogram ◽  
Perforating Artery ◽  
Ct Angiogram ◽  
Superselective Angiography ◽  
Lenticulostriate Artery ◽  
The Right ◽  
Exact Origin

Aneurysms of the lenticulostriatal perforating arteries are rare and either involve the middle cerebral artery-perforator junction or are located distally in basal ganglia. We describe a rare ruptured fusiform lenticulostriatal perforating artery aneurysm arising from a proximal M2 MCA branch, discerned on superselective microcatheter angiography, presenting solely with subarachnoid hemorrhage (SAH). A 50-year-old previously healthy man presented with diffuse SAH and negative CT angiogram. Cerebral angiogram demonstrated a 2 mm fusiform aneurysm presumably arising from the right lateral lenticulostriate perforator but the exact origin of the perforator was unclear. Superselective angiography was required to precisely delineate the aneurysm and its vessel of origin and directly influenced treatment planning (surgical trapping). Superselective microcatheter angiography provides both an option for endovascular therapy as well as more accurate delineation for surgical planning for these rare aneurysms.

scholarly journals Serial MR Imaging of Adult-Onset Rasmussen's Encephalitis

2011 ◽  
Vol 38 (1) ◽  
pp. 141-142 ◽  
Author(s):  
Myriam Irislimane ◽  
François Guilbert ◽  
Jean-Maxime Leroux ◽  
Lionel Carmant ◽  
Dang Khoa Nguyen
Keyword(s):  
Clinical Presentation ◽  
Subcortical White Matter ◽  
Adult Onset ◽  
Resonance Imaging ◽  
Rasmussen’S Encephalitis ◽  
Arm Muscles ◽  
Cerebral Biopsy ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Progressive Dysphagia

A 52-year-old woman was referred for a progressive neurological condition which started a year before with continuous irregular twitching of the right facial and arm muscles as well as the tongue and palate, followed by progressive dysphagia, right hemiparesis, ataxia, dysphasia and dysarthria. Though magnetic resonance imaging (MRI) at clinical presentation and a year after were both normal (Figure A1), Rasmussen's encephalitis (RE) was strongly suspected and treatment with corticosteroids and immunoglobulins were begun. A third MRI, two years after onset, revealed mild T2 hyperintense subcortical white matter changes over the left perisylvian region (Figure A) which confirmed our initial suspicion of RE as she now met clinical, electrophysiological and morphological criterias for RE. While waiting for a cerebral biopsy after unsatisfactory response from antiepileptic drugs, corticosteroids and immunoglobulins, her condition markedly worsened less than three years after onset with the sudden occurrence of status epilepticus requiring intubation and continuous infusions of midazolam and propofol.

scholarly journals Isolated leptomeningeal angiomatosis in the sixth decade of life, an adulthood variant of Sturge Weber Syndrome (Type III): role of advanced Magnetic Resonance Imaging and Digital Subtraction Angiography in diagnosis

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Vetrivel Muralidharan ◽  
Gaetano Failla ◽  
Mario Travali ◽  
Tiziana Liliana Cavallaro ◽  
Marco Angelo Politi
Keyword(s):  
Clinical Presentation ◽  
Subcortical White Matter ◽  
Digital Subtraction ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Hyperintense Signal ◽  
Right Cerebral Hemisphere ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome ◽  
The Right

Abstract Background Sturge-Weber syndrome (SWS) is primarily diagnosed in pediatric population, but clinical presentation in late adulthood is rarely reported. Evolution of radiological findings in the adulthood variant of SWS with isolated leptomeningeal angiomatosis has never been reported to our knowledge. Case presentation We report here a case of an isolated temporo-parieto-occipital leptomeningeal angiomatosis on the right cerebral hemisphere in a sixty-two-year-old male who presented with generalized seizure, GCS score 14/15 (E4 V4 M6) with equal and reacting pupils, psychomotor slowing, left hemineglect and grade 4 power in the left upper and lower limbs. Over a period of 48 h his neurological status deteriorated, but recovered spontaneously over a week on titration with anticonvulsants. He had a prior history of treatment for focal leptomeningitis, three years ago. Cerebrospinal fluid (CSF) analysis showed glucose of 75 mg/dL, proteins of 65 mg/dL and culture grew no organisms. On follow-up, he had intermittent episodes of focal seizure for two years. Initial, computed tomography of brain showed hyperdense lesion in the parieto-occipital convexity subarachnoid space on the right cerebral hemisphere mimicking subarachnoid hemorrhage and computed tomography angiography showed no significant abnormality. Magnetic resonance imaging (MRI) of brain showed intense pial enhancement in the right temporo-parieto-occipital region with a subtle T2W hyperintense signal in the underlying subcortical white matter without edema or infarct or mass effect. Digital subtraction cerebral angiography (DSA) showed hypertrophy of the cerebral arteries, arteriolo-capillary bed and venules in the right temporo-parieto-occipital territory associated with early arterio-capillary and venous opacification. Serial MRI done after six months, one and two years showed increase in the T2W hyperintense signal in the subcortical white matter and cortical atrophy with no changes in the pial enhancement. MR perfusion imaging showed reduced cerebral blood flow (CBF) and cerebral blood volume (CBV) in the right parieto-temporo-occipital cortical and subcortical regions and increased perfusion in the leptomeninges with reduction of the NAA / Cr ratios in spectroscopy. Conclusion Conglomeration of various radiological findings in MRI, Perfusion, MRS and DSA with the clinical presentation can aid in establishing the diagnosis of this rare presentation of SWS-type 3 variant in late adulthood.

Treatment of a Giant Basilar Artery Aneurysm With a Bridging Stent and Subsequent Coil Occlusion of the Stent

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. E510-E511 ◽  
Author(s):  
Guido Wilms ◽  
Gunnar Buyse ◽  
Johan van Loon ◽  
Geert Maleux
Keyword(s):  
Basilar Artery ◽  
Clinical Presentation ◽  
Artery Aneurysm ◽  
Fusiform Aneurysm ◽  
Total Occlusion ◽  
Coil Occlusion ◽  
Basilar Artery Aneurysm ◽  
Detachable Coils ◽  
History Of ◽  
Stent Lumen

Abstract OBJECTIVE AND IMPORTANCE To report the treatment of a symptomatic giant basilar artery aneurysm in a child. CLINICAL PRESENTATION A 7-year-old girl presented with a 2-month history of progressive right hemiparesis caused by a huge fusiform aneurysm of the basilar artery with compression of the brainstem. INTERVENTION OR TECHNIQUE The patient was treated with a bridging bare stent and occlusion of the stent lumen with detachable coils. CONCLUSION The patient experienced immediate total occlusion of the aneurysm with almost total recuperation after 1 year.

Ganglioglioma Presenting as a Meningioma: Case Report and Review of the Literature

Neurosurgery ◽  
2002 ◽  
Vol 50 (5) ◽  
pp. 1133-1136 ◽  
Author(s):  
Khawar Siddique ◽  
Michael Zagardo ◽  
Meena Gujrati ◽  
William Olivero
Keyword(s):  
Histological Analysis ◽  
Clinical Presentation ◽  
Middle Meningeal Artery ◽  
Vascular Supply ◽  
Catheter Angiography ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Axial Mass ◽  
Posterior Division ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: Gangliogliomas are intra-axial, avascular masses located predominately in the temporal lobe. A ganglioglioma that mimics a meningioma in that it is extra-axial and has a significant extracranial vascular supply has not been reported previously. CLINICAL PRESENTATION: A 12-year-old girl presented with a right temporoparietal mass. A neurological examination revealed nothing abnormal, and the girl's symptoms were limited to headaches. INTERVENTION: Magnetic resonance imaging revealed an extra-axial mass, and cerebral catheter angiography revealed a blood supply mainly from the posterior division of the right middle meningeal artery. Intraoperative findings confirmed the extra-axial location of the tumor, and histological analysis revealed that the tumor was a ganglioglioma. CONCLUSION: This report confirms that gangliogliomas can present as extra-axial, vascular masses that are similar to meningiomas.

Acute Spinal Epidural Hematoma and Cranial Interdural Hematoma Due to a Rupture of a Posterior Communicating Artery Aneurysm: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. E1000-E1004 ◽  
Author(s):  
Andrea Bartoli ◽  
Marc Kotowski ◽  
Vitor Mendes Pereira ◽  
Karl Schaller
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Epidural Hematoma ◽  
Clinical Presentation ◽  
Artery Aneurysm ◽  
Posterior Communicating Artery ◽  
Spinal Epidural Hematoma ◽  
Anterior Communicating Artery ◽  
Posterior Communicating Artery Aneurysm ◽  
The Right ◽  
Spinal Epidural

Abstract BACKGROUND AND IMPORTANCE: We describe an unusual presentation of a ruptured aneurysm of the posterior communicating artery with an acute intracranial hematoma between the dural layers associated with an acute spinal epidural hematoma descending to L1. CLINICAL PRESENTATION: A 35-year-old woman presented 3 hours after ictus with a postcoital headache, neck stiffness, and bilateral abducens cranial nerve palsy. No other neurological deficits were present. Clinically, she had a subarachnoid hemorrhage World Federation of Neurosurgical Societies grade 1. CT scan demonstrates an acute subdural hematoma, extending from the right parasellar region, around the clivus, tentorium, and falx. Angio-CT showed a posterior communicating artery aneurysm and an anterior communicating artery aneurysm and an extension of the hematoma to the cervical spine. This justified a spinal and cerebral MRI that confirmed an extension of the hematoma to the epidural space at the cervical, thoracic, and lumbar levels. Three-dimensional digital subtraction angiography confirmed aneurysms on the right posterior communicating artery and on the anterior communicating artery. Both aneurysms were completely occluded by coiling. With reference to the concept of the cranial subdural compartment described in studies conducted using an electron microscope, this group of hematomas was classified as interdural. CONCLUSION: Ruptured aneurysm of the posterior communicating artery may cause cranial acute interdural hematoma with a typical subarachnoid hemorrhage clinical presentation, and it rarely can extend to spinal epidural space.

Cervical Spine Dural Arteriovenous Fistula With Coexisting Spinal Radiculopial Artery Aneurysm Presenting as Subarachnoid Hemorrhage

Neurosurgery ◽  
2011 ◽  
Vol 70 (1) ◽  
pp. 259-263 ◽  
Author(s):  
Joshua W. Lucas ◽  
Jesse Jones ◽  
Azadeh Farin ◽  
Paul Kim ◽  
Steven L. Giannotta
Keyword(s):  
Native American ◽  
Cervical Spine ◽  
Subarachnoid Hemorrhage ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Artery Aneurysm ◽  
Sudden Onset ◽  
Spinal Dural Arteriovenous Fistula ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE We present a patient with a cervical spine dural arteriovenous fistula associated with a radiculopial artery aneurysm at the same vertebral level presenting with subarachnoid hemorrhage. CLINICAL PRESENTATION A 45-year-old Native American man presented with sudden-onset severe headache, lethargy, and right hemiparesis. Computed tomography (CT) of the head showed subarachnoid hemorrhage and hydrocephalus. A subsequent CT of the neck showed an anterior spinal subdural hematoma from C2 to C4 causing mild cord compression. Carotid and vertebral angiography failed to demonstrate an intracranial aneurysm, but showed a spinal dural arteriovenous fistula originating from the right vertebral artery at the C5 neuroforamen. The severity of the patient's symptoms, atypical for rupture of a dural arteriovenous fistula, prompted more thorough angiographic evaluation. Thus, injection of the right thyrocervical trunk was performed, demonstrating a 4-mm spinal radiculopial artery aneurysm. Following ventriculostomy, a hemilaminectomy from C4 to C7 was performed with disconnection of the fistula from its drainage system. Subsequent resection of the aneurysm, which was determined to be the cause of the hemorrhage, was accomplished. The patient improved neurologically and was discharged to rehabilitation. CONCLUSION Spinal cord aneurysms from a separate vascular distribution may coexist with spinal dural arteriovenous fistulas. In the setting of spinal hemorrhage, especially in situations with an atypical clinical presentation, comprehensive imaging is indicated to rule out such lesions.

scholarly journals Lower Gastrointestinal Bleeding in Klippel-Trenaunay Syndrome: A Case Report

2018 ◽  
Vol 36 (1) ◽  
pp. 83
Author(s):  
Nawaporn Assanangkornchai ◽  
Kumpol Aiempanakit ◽  
Siripan Sangmala
Keyword(s):  
Magnetic Resonance Imaging ◽  
Clinical Presentation ◽  
Vascular Malformations ◽  
Imaging Study ◽  
Lower Gastrointestinal Bleeding ◽  
Venous Malformations ◽  
Resonance Imaging ◽  
Gastrointestinal Complications ◽  
The Right ◽  
Klippel Trenaunay Syndrome

Klippel-Trenaunay syndrome (KTS) is a rare, vascular malformation. The major clinical presentation is an overgrowth involving the extremities. The diagnosis of KTS was based on an imaging study, which revealed vascular malformations. The author’s report is of a 36-year Thai man with; hypertrophy of the right lower extremity, whilst having suffered from two-months of bloody defecation. The magnetic resonance imaging showed venous malformations with soft tissue hypertrophy of the affected limb, genitalia and rectum. The patient was diagnosed with: KTS accompanied by gastrointestinal complications.

Trigeminal Neuralgia Caused by a Pontine Abscess: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. E1450-E1452 ◽  
Author(s):  
Ahmet Bekar ◽  
Hasan Kocaeli ◽  
Emel Yilmaz ◽  
Şeref Doğan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Sphenoid Sinus ◽  
Clinical Presentation ◽  
Resonance Imaging ◽  
Repeat Magnetic Resonance Imaging ◽  
Corneal Reflex ◽  
History Of ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: Various intracranial abnormalities, including infectious conditions, may manifest as trigeminal neuralgia. CLINICAL PRESENTATION: A 33-year-old man presented with a 15-day history of right-sided facial pain and numbness. Neurological examination revealed diminished corneal reflex and facial sensation in the right V1–V2 distribution. Magnetic resonance imaging revealed a contrast-enhancing lesion centered at the right pons with extension of the enhancement to the sphenoid sinus. INTERVENTION: Broad-spectrum antibiotics were administered for 6 weeks. This resulted in alleviation of symptoms and resolution of the lesion as revealed by repeat magnetic resonance imaging. CONCLUSION: Presentation of a pons abscess with trigeminal neuralgia is rare, and to the best of our knowledge has not been reported previously. The patient was treated successfully with antibiotics alone.

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