Bilateral basal ganglia calcifications visualised on CT scan.

Pleomorphic Xanthoastrocytomas (PXAs) are rare neoplasm of all astrocytic glial tumors, which occurs commonly in children and young adulthood. We present a case of 75-year male who presented with right side involuntary movements, unconsciousness and tongue bite. On radiological examination CT Scan Head (plain) showed well circumscribed isodense lesion measuring 7.2 x 5.6 x 4.8 cm at the temporoparietal region left side causing displacement of basal ganglia. On histopathological examination, diagnosed as pleomorphic xanthoastrocytoma, of left temporoparietal region. We present this report for its presentation at late age, its clinical, radiological and histomorphological features.

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Clinical correlations of CT scan-detected calcifications of the basal ganglia

Annals of Neurology ◽

10.1002/ana.410060608 ◽

1979 ◽

Vol 6 (6) ◽

pp. 507-511 ◽

Cited By ~ 55

Author(s):

Martin J. Murphy

Keyword(s):

Basal Ganglia ◽

Ct Scan ◽

Clinical Correlations

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Cerebral lipiodol embolisation

Practical Neurology ◽

10.1136/practneurol-2021-002952 ◽

2021 ◽

pp. practneurol-2021-002952

Author(s):

Lisa Batcheller ◽

Mark Thaller ◽

Ben Wright

Keyword(s):

Intensive Care ◽

Basal Ganglia ◽

Ct Scan ◽

Thoracic Duct ◽

Muscle Tone ◽

Talc Pleurodesis ◽

Chyle Leak ◽

Cognitive Limitations ◽

Double Incontinence ◽

Conscious Level

Cerebral lipiodol embolisation is a rare but serious complication of lymphangiography. A man in his seventies had undergone lymphangiography for a refractory chyle leak following oesophagectomy. The day after lymphangiography, his conscious level dropped with bilaterally miotic pupils, increased muscle tone and double incontinence. CT scan of the head showed patchy high density throughout basal ganglia, cortex and cerebellum but no infarct, in keeping with lipiodol embolisation. He was managed initially in intensive care and subsequently underwent thoracoscopy with clipping and suturing of the left thoracic duct, and later a talc pleurodesis. At 3 months, he had some cognitive limitations and was walking with a stick.

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Evaluation of Volumetric Change of Intracerebral Hemorrhage in Patients Treated with Thrombolysis for Intraventricular Hemorrhage

Neurocritical Care ◽

10.1007/s12028-020-01054-7 ◽

2020 ◽

Author(s):

Franziska Staub-Bartelt ◽

Jasper Hans van Lieshout ◽

Thomas Beez ◽

Rainer Kram ◽

Daniel Hänggi ◽

...

Keyword(s):

Basal Ganglia ◽

Intracerebral Hemorrhage ◽

Ct Scan ◽

Intraventricular Hemorrhage ◽

Volume Reduction ◽

Percentage Reduction ◽

Hematoma Volume ◽

Group A ◽

Group B ◽

Lysis Therapy

Abstract Background Intraventricular hemorrhage (IVH) is often caused by irruption of intracerebral hemorrhage (ICH) of basal ganglia or thalamus into the ventricular system. Instillation of recombinant tissue plasminogen activator (rtPA) via an external ventricular drainage (EVD) has been shown to effectively decrease IVH volumes while the impact of rtPA instillation on ICH volumes remains unclear. In this series, we analyzed volumetric changes of ICH in patients with and without intrathecal lysis therapy. Methods Between 01/2013 and 01/2019, 36 patients with IVH caused by hemorrhage of basal ganglia, thalamus or brain stem were treated with rtPA via an EVD (Group A). Initial volumes were determined in the first available computed tomography (CT) scan, final volumes in the last CT scan before discharge. During the same period, 41 patients with ICH without relevant IVH were treated without intrathecal lysis therapy at our neurocritical care unit (Group B). Serial CT scans were evaluated separately for changes in ICH volumes for both cohorts using OsiriX DICOM viewer. The Wilcoxon signed-rank test was performed for statistical analysis in not normally distributed variables. Results Median initial volume of ICH for treatment Group A was 6.5 ml and was reduced to 5.0 ml after first instillation of rtPA (p < 0.01). Twenty-six patients received a second treatment with rtPA (ICH volume reduction 4.5 to 3.3 ml, p < 0.01) and of this cohort further 16 patients underwent a third treatment (ICH volume reduction 3.0 ml to 1.5 ml, p < 0.01). Comparison of first and last CT scan in Group A confirmed an overall median percentage reduction of 91.7% (n = 36, p < 0.01) of ICH volumes and hematoma resolution in Group A was significantly more effective compared to non-rtPA group, Group B (percentage reduction = 68%) independent of initial hematoma volume in the regression analysis (p = 0.07, mean 11.1, 95%CI 7.7–14.5). There were no adverse events in Group A related to rtPA instillation. Conclusion Intrathecal lysis therapy leads to a significant reduction in the intraparenchymal hematoma volume with faster clot resolution compared to the spontaneous hematoma resorption. Furthermore, intrathecal rtPA application had no adverse effect on ICH volume.

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Fahr's Syndrom e: A rare case- Presented as Acute Ischaemic Stroke

Medicine Today ◽

10.3329/medtoday.v29i1.33862 ◽

2017 ◽

Vol 29 (1) ◽

pp. 45-46

Author(s):

Devendra Nath Sarkar ◽

Devavrata Sarkar ◽

AKM Zahin ◽

MA Ohab ◽

Md Shahin Miah ◽

...

Keyword(s):

Basal Ganglia ◽

Ischaemic Stroke ◽

Ct Scan ◽

Acute Ischaemic Stroke ◽

Rare Case ◽

Intracranial Calcification ◽

Variable Size ◽

Rare Syndrome ◽

Irregular Variable ◽

Fahr Disease

Fahr's syndrome refers to a rare syndrome characterized by symmetrical and bilateral intracranial calcification. We present a 65-year-old female with Fahr disease, presenting with headache with acute ischaemic stroke with left sided hemiplegia. CT scan of brain reveals irregular variable size hyperdense areas are noted in both basal ganglia regions and in both cerebellar hemisphere.Medicine Today 2017 Vol.29(1): 45-46

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Manajemen Pasien Stroke Perdarahan Spontan dengan Komorbid Penyakit Paru Obstruktif Kronik yang Terjadi Bronkhospasme Intraoperasi

Jurnal Neuroanestesi Indonesia ◽

10.24244/jni.v8i2.222 ◽

2019 ◽

Vol 8 (2) ◽

pp. 105-11

Author(s):

Radian Ahmad Halimi ◽

Dewi Yulianti Bisri

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Basal Ganglia ◽

Ct Scan ◽

Pulmonary Disease ◽

Pharmacological Therapy ◽

Chronic Obstructive ◽

Anesthesia Induction ◽

Obstructive Pulmonary Disease ◽

Left Limb ◽

History Of

Stroke perdarahan spontan dan penyakit paru obstruktif kronik (chronic obstructive pulmonary disease/COPD) merupakan dua penyakit yang memiliki angka morbiditas dan mortalitas yang paling tinggi di dunia. Kondisi COPD akan meningkatkan resiko terjadinya stroke, selain itu dapat mengakibatkan terjadinya hipoksemia dan hiperkapnia. Seorang pria berusia 62 tahun datang ke unit gawat darurat karena mengalami penurunan kesadaran dan tidak dapat menggerakkan anggota tubuh sebelah kiri sejak 1 hari, pasien memiliki riwayat hipertensi namun tidak rutin meminum obat, pasien memiliki riwayat sering sesak, dan berdasarkan pemeriksaan fisik didapatkan kondisi barrel chest. Berdasarkan pemeriksaan CT-scan kepala didapatkan perdarahan intrakranial spontan pada basal ganglia sinistra. Pasien dilakukan tindakan kraniotomi evakuasi, namun 2 jam setelah dilakukan induksi anestesi terjadi kondisi desaturasi, hiperkapnia, peningkatan tekanan jalan nafas, dan ditemukan wheezing pada kedua lapang paru, kemudian diberikan terapi farmakologis dan non farmakologis untuk mengatasi kondisi bronkospasme. Pascabedah dilakukan pemanjangan ventilasi mekanik hingga pasien memenuhi kriteria untuk dilakukan ekstubasi. Penanganan pasien stroke dengan komorbid COPD membutuhkan pemahaman yang lebih mendalam mengenai interaksi otak dengan fungsi pernafasan akibat perubahan fisiologi dan patofisiologi pasien COPD. Management of Spontaneous Intracranial haemorhage with Comorbids Chronic Obstructive Pulmonary Disease Occurring Intraoperative BronchospasmAbstractStroke and chronic obstructive pulmonary disease (COPD) are the two diseases that have the highest morbidity and mortality rates in the world. COPD conditions will increase the risk of stroke, but it can lead to hypoxemia and hypercapnia. A 62-year-old man came to the emergency room because of a decreased consciousness and was unable to move the left limb since 1 day, the patient had a history of hypertension but did not regularly take medication, the patient had a history of frequent tightness, and based on physical examination was obtained barrel chest condition. Based on a head CT scan, spontaneous intracranial hemorrhage occurs in the left basal ganglia. Evacuation craniotomy was performed, but 2 hours after anesthesia induction occurred conditions of desaturation, hypercapnia, increased airway pressure, and wheezing was found in both lung fields, then given pharmacological and non-pharmacological therapy to overcome the condition of bronchospasm. After surgery, lengthening of mechanical ventilation is done until the patient meets the criteria for extubation. The treatment of stroke patients with co-morbid COPD requires a deeper understanding of brain interactions with respiratory function due to changes in physiology and pathophysiology of COPD patients.

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Fahr’s Disease: Report of Two Cases

Asian Journal of Medical Sciences ◽

10.3126/ajms.v2i2.3207 ◽

2011 ◽

Vol 2 (2) ◽

pp. 120-123

Author(s):

Om Prakash Sharma ◽

Senthil Shanmugam

Keyword(s):

Basal Ganglia ◽

Ct Scan ◽

Key Words ◽

Cerebrovascular Accident ◽

Cerebral Hemispheres ◽

Medical Sciences ◽

Fahr’S Disease ◽

Intracranial Calcifications ◽

Fahr's Disease ◽

Fahr’S Syndrome

Two cases of Fahr’s disease (one female and one male) are reported here. One is young and symptomatic with neuropsychiatric disturbances. The second case is old and asymptomatic, detected incidentally on CT scan when he presented with cerebrovascular accident. Both of them had intracranial calcifications in bilateral basal ganglia and cerebral hemispheres. CT scan helped in establishing the diagnosis. Key Words: Fahr’s disease; Fahr’s syndrome; Bilateral striopallido dentate calcifications DOI: http://dx.doi.org/10.3126/ajms.v2i2.3207 Asian Journal of Medical Sciences 2 (2011) 120-123

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Angiographic A-V Shunt during Interventional Thrombolysis for Acute Cerebral Embolism

Interventional Neuroradiology ◽

10.1177/15910199970030s213 ◽

1997 ◽

Vol 3 (2_suppl) ◽

pp. 75-78 ◽

Cited By ~ 5

Author(s):

S. Fukazawa ◽

R. Waki ◽

A. Hidaka ◽

R. Kishimoto ◽

K. Kimura ◽

...

Keyword(s):

Basal Ganglia ◽

Ct Scan ◽

Poor Prognosis ◽

Disease Onset ◽

Cerebral Embolism ◽

Hemorrhagic Complication ◽

High Incidence ◽

Group 2 ◽

Angiographic Findings ◽

Group 1

In order to predict the post-therapeutic hemorrhagic complication of interventional thrombolysis, we retrospectively examined angiographic findings and other factors in 44 patients with acute cerebral embolism. All patients were super selectively catheterized within 5 hours of onset and received a fixed regimen of urokinase or t-PA, unless recanalization was achieved or deterioration was apparent before total infusion. Immediate post-therapeutic CT scan revealed hematoma within the basal ganglia in 10 patients (group 1) and no hemorrhage in the remaining 34 (group 2). A series of angiograms during the therapy showed A-V shunt from lenticulostriate arteries to thalamostriate vein in 7 of 10 cases in group 1; no case in group 2 was accompanied by such abnormal shunt. Prognosis after the therapy was worse in group 1 than in group 2. No other factors, such as therapeutic timing after the disease onset or total doses of urokinase or t-PA infused, differed between the two groups. These findings indicate that angiographic A-V shunt during therapy is a predictive sign of a high incidence of hemorrhagic complication. We recommend performing several angiographic controls during therapy and when A-V shunt is detected, the therapy should be discontinued to prevent hemorrhage which leads to a poor prognosis.

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Stroke After Minor Head Trauma in Infants and Young Children With Basal Ganglia Calcification: A Lenticulostriate Vasculopathy?

Journal of Child Neurology ◽

10.1177/0883073817750501 ◽

2018 ◽

Vol 33 (2) ◽

pp. 146-152 ◽

Cited By ~ 7

Author(s):

Jatinder Singh Goraya ◽

Shivankshi Berry ◽

Kavita Saggar ◽

Archana Ahluwalia

Keyword(s):

Basal Ganglia ◽

Ct Scan ◽

Head Trauma ◽

Brain Magnetic Resonance Imaging ◽

Neurological Deficits ◽

Minor Head Trauma ◽

Basal Ganglia Calcification ◽

Lost To Follow Up ◽

Lenticulostriate Vasculopathy

The authors retrospectively reviewed charts of the children with basal ganglia stroke who either had preceding minor head injury or showed basal ganglia calcification on computed tomography (CT) scan. Twenty children, 14 boys and 6 girls were identified. Eighteen were aged between 7 months to 17 months. Presentation was with hemiparesis in 17 and seizures in 3. Preceding minor head trauma was noted in 18. Family history was positive in 1 case. Bilateral basal ganglia calcification on CT scan was noted in 18. Brain magnetic resonance imaging done in 18 infants showed acute or chronic infarcts in basal ganglia. Results of other laboratory and radiological investigations were normal. Four infants were lost to follow-up, 9 achieved complete or nearly completely recovery, and 7 had persistent neurological deficits. Basal ganglia calcification likely represents mineralized lenticulostriate arteries, a marker of lenticulostriate vasculopathy. Abnormal lenticulostriate vessels are vulnerable to injury and thrombosis after minor head trauma resulting in stroke.

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