scholarly journals Tuberculous Pachymeningitis Presenting as a Diffused Dural Thickening in a Patient with Chronic Headache and Recurrent Neurological Abnormalities for More than a Decade: A Case Report and a Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
C. L. Fonseka ◽  
T. E. Kanakkahewa ◽  
S. D. A. L. Singhapura ◽  
J. S. Hewavithana ◽  
L. P. Kolambage ◽  
...  
Keyword(s):  
Case Report ◽  
Chronic Headache ◽  
Facial Nerve Palsy ◽  
Extrapulmonary Tuberculosis ◽  
Granulomatous Inflammation ◽  
Mantoux Test ◽  
Resonance Imaging ◽  
Neurological Signs ◽  
Neurological Abnormalities ◽  
Contrast Enhanced

Background. Tuberculous pachymeningitis is a rare form of extrapulmonary tuberculosis usually suspected from the detection of thickening of the dura in contrast-enhanced magnetic resonance imaging. Progressive nature of the disease can lead to chronic headache with focal neurological signs due to compression from the thickened dura. Case Report. We report a 40-year-old female who presented with chronic headache over a decade associated with recurrent neurological abnormalities including optic neuritis, hemisensory loss, migraine, facial nerve palsy, and recurrent vertigo. Although there was an initial perceived response to steroids, the patient had a subsequent progressive course. On investigations, she was found to have a diffused dural thickening on contrast MRI with a strongly positive Mantoux test with caseating necrotizing granulomatous inflammation on dural histology. With initiation of antituberculous medication with steroids, the patient markedly improved, and the medication for tuberculosis was continued for a year with good response. Conclusion. Primary tuberculous pachymeningitis should be suspected in a patient complaining of prolonged headache with focal neurological signs when MRI evidence of dural thickening is detected, and another focus of tuberculosis was not found. Prompt suspicion with image-guided dural biopsy for histology would help to confirm the diagnosis.

scholarly journals Not just eosinophilic fasciitis

2021 ◽  
Vol 14 (1) ◽  
pp. 121-124
Author(s):  
Razvan Chirila ◽  
◽  
Elena Raluca Cristea ◽  
Monica Roxana Purcarea ◽  
Laura Carina Tribus ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Muscle Weakness ◽  
Rare Case ◽  
Chronic Treatment ◽  
Eosinophilic Fasciitis ◽  
Resonance Imaging ◽  
Progressive Muscle Weakness ◽  
Contrast Enhanced

This case report describes a rare case of progressive muscle weakness in a patient treated for eosinophilic fasciitis (EF) for many years before being diagnosed with a second autoimmune disease: dermatomyositis. Our case is a report of a 65-year-old male diagnosed with eosinophilic fasciitis 7 years before being evaluated in our service at Mayo Clinic in Jacksonville, Florida, due to progressive muscle weakness despite the chronic treatment with methotrexate. Contrast-enhanced magnetic resonance imaging of the lower extremity showed enhancement throughout the thigh musculature, which led us to pursue biopsies of the fascia and muscle in order to confirm the diagnosis of EF associated with myopathy. This case illustrates the need to consider the possibility of myopathy in patients diagnosed with EF whenever muscle weakness is more prominent than expected.

scholarly journals Contrast enhanced imaging features of liver metastasis from a meningeal solitary fibrous tumor: a case report

2018 ◽  
Vol 20 (3) ◽  
pp. 392 ◽  
Author(s):  
Beilei Lu ◽  
Qing Lu ◽  
Beijian Huang ◽  
Haixia Yuan ◽  
Chaolun Li
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Liver Metastasis ◽  
Solitary Fibrous Tumor ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Fibrous Tumor ◽  
Enhanced Imaging

A solitary fibrous tumor seldom originates from the meninges, and the accuracy of imaging modalities in the diagnosis of meningeal SFT metastasisis is perlexing. Contrast enhanced imaging modalities, such as contrast enhanced ultrasound and contrast enhanced magnetic resonance imaging are valuable in the differential diagnosis of hepatic neoplasms. This case report demonstrated the contrast enhanced ultrasound and enhanced magnetic resonance imaging features of one case of liver metastasis from a menigeal solitary fibrous tumor.

scholarly journals Parotid gland cholesteatoma in a 23-year-old male: Case report

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774908
Author(s):  
Krzysztof Piersiala ◽  
Hanna Klimza ◽  
Joanna Jackowska ◽  
Małgorzata Wierzbicka
Keyword(s):  
Case Report ◽  
Parotid Gland ◽  
Soft Tissues ◽  
Facial Nerve Palsy ◽  
Parotid Tumor ◽  
Resonance Imaging ◽  
Stylomastoid Foramen ◽  
First Case ◽  
Parotid Surgery ◽  
The Right

Cholesteatoma is a pathological tissue that may extend into all parts of temporal bone and rarely, as this study highlights, beyond its structures. Nevertheless, the spread outside the mastoid tip into the soft tissues of the neck or parotid space is very rare. The case of 23-year-old male with right parotid mass is presented. The patient had history (2006, 2009, and 2012) of three tympanoplastics for recurrent right ear cholesteatoma. The parotid tumor was revealed incidentally in magnetic resonance imaging in January 2016, but the imaging was inconclusive. After 6 months, the patient developed right-sided facial nerve palsy. The second look of the right ear was performed with simultaneous parotid surgery. The ear was healed and free of cholesteatoma, but the parotid mass resembled the cholesteatoma confirmed later on by histological examination. The tumor extended from stylomastoid foramen. This case was unusual as the disease had extended beyond the ear with the bony parts of the mastoid being preserved. To our knowledge, this is the first case report to describe a parotid gland cholesteatoma not being an extension of a cholesteatoma present in the tympanic cavity and entering the parotid gland via stylomastoid foramen.

scholarly journals The use of porous tantalum cages in the treatment of unremitting spondylodiscitis: a case report

2018 ◽  
Vol 87 (1-2) ◽  
Author(s):  
Samo Karel Fokter ◽  
Gregor Rečnik
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Porous Tantalum ◽  
Transpedicular Fixation ◽  
Contrast Enhanced

Background: Unsuccessful medical treatment of pyogenic multifocal spondylodiscitis including signs of sepsis and unremitting pain is challenging. The aim of our report was to present a case of multilevel spondylodiscitis successfully treated by posterior lumbar interbody fusion using porous tantalum cages.Case presentation: A 59-year-old male was diagnosed with spondylodiscitis at T8-T9 level. Although treated with antibiotics, the patient again presented with worsening of systemic signs of infection and back pain. Contrast-enhanced magnetic resonance imaging studies revealed spondylodiscitis at L1 to S1 level. Posterior lumbar interbody bone fusion with tantalum cages from L1 to S1 was performed. The inflammation rapidly subsided. Computer tomography studies showed a stable construct at 24 months.Conclusion: Porous tantalum cages used in combination with transpedicular fixation seem to be a sound alternative to interbody devices made from other materials when treating spondylodiscitis cases without definite osseous destruction.

scholarly journals Cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in an immunocompetent patient: A case report and review of literature

2020 ◽  
Author(s):  
Muhammad Mushtaq ◽  
Saad Bin Zafar Mahmood ◽  
Nosheen Nasir ◽  
Malik Saad Rashid ◽  
Memoona Irshad ◽  
...  
Keyword(s):  
Case Report ◽  
Granulomatous Inflammation ◽  
Immunocompetent Patient ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
Dematiaceous Fungi ◽  
Limb Weakness ◽  
Diagnostic Skills ◽  
Facial Numbness ◽  
Significant Mortality

Background and Purpose: Rhinocladiella mackenziei is a neurotropic fungus, which can cause devastating intracerebral infections with up to 100% fatality rate. It is difficult to isolate this fungus in laboratory as it grows slowly and requires diagnostic skills. Case report: A 42-year-old Pakistani man presented with headache, facial numbness, progressive upper limb weakness, and dysarthria. Magnetic resonance imaging of thebrain showed a space-occupying lesion in the basal ganglia region. The patient underwent supratentorial craniotomy for biopsy and excision. Histopathology of the specimen revealed granulomatous inflammation with abscess formation. Periodic acidSchiff special stains highlighted the presence of numerous septate fungal hyphae. The results revealed the growth of dematiaceous fungi, which were morphologically classified as R. mackenziei. The patient is currently stable and is being on amphotericin and posaconazole, along with neurorehabilitation therapy. Conclusion: Rhinocladiella mackenziei brain abscess is a devastating infection with significant mortality. This condition should be suspected in patients with brain abscessfrom high endemic areas

scholarly journals Neurovascular and perfusion imaging findings in coronavirus disease 2019: Case report and literature review

2020 ◽  
Vol 33 (5) ◽  
pp. 368-373 ◽  
Author(s):  
Matheus Dorigatti Soldatelli ◽  
Lázaro Faria do Amaral ◽  
Viviane Cordeiro Veiga ◽  
Salomón Soriano Ordinola Rojas ◽  
Samir Omar ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Intensive Care Unit ◽  
Central Nervous System ◽  
Nervous System ◽  
Intensive Care ◽  
Case Report ◽  
Central Nervous System Involvement ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Neurological Signs

Central nervous system involvement in severe acute respiratory syndrome caused by coronavirus disease 2019 (COVID-19) has increasingly been recognised in the literature, and possible mechanisms of neuroinvasion, neurotropism and neurovirulence have been described. Neurological signs have been described in 84% of COVID-19 intensive care unit patients, and haemostatic abnormalities in such patients may play an important role, with a broad spectrum of neuroimaging findings. This report describes the magnetic resonance imaging neurovascular findings in an acutely ill patient with COVID-19, including perfusion abnormalities depicted in the arterial spin labelling technique.

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