scholarly journals An Intracranial Extradural Dermoid Cyst Presenting with Two Dermal Sinuses and an Abscess in a Child

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Aysha Albastaki ◽  
Reem AlThawadi ◽  
Janan Alajaimi ◽  
Khawla F. Ali ◽  
Talal Almayman
Keyword(s):  
Dermoid Cyst ◽  
Histological Analysis ◽  
Brain Mri ◽  
Final Diagnosis ◽  
Neurological Deficits ◽  
Cutaneous Lesions ◽  
Complete Excision ◽  
Clinical Presentations ◽  
Early Imaging ◽  
Identification And Characterization

Dermoid cysts account for only a small fraction of intracranial masses, with extradural dermoid cysts being considered a much rarer entity than those located intradurally. Intracranial dermoid cysts vary in clinical presentations: some maybe asymptomatic whilst others harbor features of raised intracranial pressure, neurological deficits, or even aseptic meningitis. Dermoid cysts may also present with cutaneous lesions. Herein, we report a rare case of a 1-year-old female presenting with a midline, scalp abscess. Brain MRI revealed an intracranial, extradural tumor, with features suggestive of a dermoid cyst, unusually located in the crista galli, and complicated by the formation of two cutaneous sinus tracts. After identification and characterization by MRI, bitemporal craniotomy was performed with complete excision of the mass and sinus tracts. Histological analysis confirmed dermoid cyst as the final diagnosis. Postoperatively, the patient recovered fully and had no evidence of recurrence in subsequent visits. The case mentioned above highlights the rarity of such a presentation for an intracranial extradural dermoid cyst and the vitality of early imaging for midline cutaneous lesions for identification of intracranial extensions and avoidance of detrimental consequences.

Primary Benign Brachial Plexus Tumors

Neurosurgery ◽  
2011 ◽  
Vol 70 (1) ◽  
pp. 220-233 ◽  
Author(s):  
Ketan I. Desai
Keyword(s):  
Brachial Plexus ◽  
World Literature ◽  
Surgical Intervention ◽  
Neurological Deficits ◽  
Complete Excision ◽  
Surgical Strategies ◽  
Clinical Presentations ◽  
King Edward Memorial Hospital ◽  
Neurological Insult ◽  
Eventual Outcome

Abstract Primary benign brachial plexus tumors are rare. They pose a great challenge to the neurosurgeon, because the majority of patients present with minimal or no neurological deficits. Radical to complete excision of the tumor with preservation of neurological function of the involved nerve is an ideal surgical treatment option with benign primary brachial plexus tumor surgery. We present a review article of our 10-year experience with primary benign brachial plexus tumors surgically treated at King Edward Memorial Hospital and P.D. Hinduja National Hospital from 2000 to 2009. The clinical presentations, radiological features, surgical strategies, and the eventual outcome following surgery are analyzed, discussed, and compared with available series in the world literature. Various difficulties and problems faced in the management of primary benign brachial plexus tumors are analyzed. Irrespective of the tumor size, the indications for surgical intervention are also discussed. The goal of our study was to optimize the treatment of patients with benign brachial plexus tumors with minimal neurological deficits. It is of paramount importance that brachial plexus tumors be managed by a peripheral nerve surgeon with expertise and experience in this field to minimize the neurological insult following surgery.

scholarly journals Acutely Altered Mental Status as the Main Clinical Presentation of Multiple Strokes in Critically Ill Patients With COVID-19.

2020 ◽  
Author(s):  
Carolina Díaz-Pérez ◽  
Carmen Ramos ◽  
Alberto López-Cruz ◽  
José Muñoz Olmedo ◽  
Jimena Lázaro González ◽  
...  
Keyword(s):  
Critically Ill ◽  
Mental Status ◽  
Critically Ill Patients ◽  
Clinical Presentation ◽  
Brain Mri ◽  
Altered Mental Status ◽  
Neurological Deficits ◽  
Cutaneous Lesions ◽  
Pulmonary Angiogram ◽  
Occipital Lobes

Abstract Background and aims:Cerebral infarction in COVID-19 patients might be associated with a hypercoagulable state related to a systemic inflammatory response. Its diagnosis might be challenging. We present two critically ill patients with COVID-19 who presented acutely altered mental status as the main manifestation of multiple strokes.Methods:Clinical presentation and diagnostic work-up of the patients.Results:Two patients in their sixties were hospitalized with a bilateral pneumonia COVID-19. They developed respiratory failure and were admitted to ICU for mechanical ventilation and intense medical treatment. They were started on low-molecular-weight heparin since admission. Their laboratory results showed lymphopenia and increased levels of C-reactive protein and D-dimer. Case 1 developed hypofibrinogenemia and presented several cutaneous lesions with biopsy features of thrombotic vasculopathy. Case 2 was performed a CT pulmonary angiogram at ICU showing a bilateral pulmonary embolism. When waking up, both patients were conscious but with a remarkable global altered mental status without focal neurological deficits. A brain MRI revealed multiple acute bilateral ischemic lesions with areas of hemorrhagic transformation in both patients (Case 1: affecting the left frontal and temporal lobes and both occipital lobes; Case 2: affecting both frontal and left occipital lobes). Cardioembolic source and acquired antiphospholipid syndrome were ruled out. COVID-19-associated coagulopathy was suspected as the possible main etiology of the strokes.Conclusion:Acutely altered mental status might be the main manifestation of multiple brain infarctions in critically ill COVID-19 patients. It should be specially considered in those with suspected COVID-19-associated coagulopathy. Full-dose anticoagulation and clinical-radiological monitoring might reduce their neurological consequences.

scholarly journals Gasperini Syndrome: A Case Report and Systematic Review and Proposing a New Definition

2020 ◽  
Vol 12 (3) ◽  
pp. 433-439
Author(s):  
Riwaj Bhagat ◽  
Siddharth Narayanan ◽  
Marwa Elnazeir ◽  
Thong Diep Pham ◽  
Robert Paul Friedland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Mri ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
The Other ◽  
Neurological Deficits ◽  
Brainstem Stroke ◽  
Neurological Features ◽  
The Right ◽  
Core Features

Gasperini syndrome (GS), a rare brainstem syndrome, is featured by ipsilateral cranial nerves (CN) V–VIII dysfunction with contralateral hemibody hypoesthesia. While there have been 18 reported cases, the GS definition remains ambiguous. We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute brainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three core features (ipsilateral CN V, VIII palsies and contralateral hemibody hemihypalgesia). Additionally, GS, similar to Wallenberg’s syndrome, represents a spectrum that can have other associated neurological features. The revised definition presented in this study may enlighten physicians with the immediate recognition of the syndrome and help improve clinical localization of the lesions and its management.

Proteus syndrome in pregnancy: A case report

2020 ◽  
pp. 1753495X2097079
Author(s):  
Niccole Ranaei-Zamani ◽  
Mandeep K Kaler ◽  
Rehan Khan
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Proteus Syndrome ◽  
Cutaneous Lesions ◽  
Genetic Syndrome ◽  
Skeletal Tissue ◽  
First Case ◽  
Large Teaching Hospital ◽  
Clinical Presentations ◽  
In Pregnancy

Proteus syndrome is a rare, multi-system, genetic syndrome characterised by atypical and excessive growth of skeletal tissue. Clinical presentations include abnormal musculoskeletal growth and cutaneous lesions. Due to its rarity, there have been a limited number of published case reports of Proteus syndrome. This is the first case report on the management of Proteus syndrome in pregnancy. We present the case of a pregnant woman with Proteus syndrome in her first pregnancy in a large teaching hospital and discuss the considerations and challenges faced in her antenatal, intrapartum and postnatal care.

Pediatric Reversible Cerebral Vasoconstriction Syndrome: Two Unique Cases with a Review of all Reported Children

2021 ◽  
Author(s):  
Neelu Desai ◽  
Rahul Badheka ◽  
Nitin Shah ◽  
Vrajesh Udani
Keyword(s):  
Magnetic Resonance ◽  
Cerebral Arteries ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Neurological Deficits ◽  
Cerebral Vasoconstriction ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Mr Angiogram

AbstractReversible cerebral vasoconstriction syndrome (RCVS) has been well described in adults, but pediatric cases are yet under recognized. We describe two children with RCVS and review similar already published pediatric cases. The first patient was a 10-year-old girl who presented with severe headaches and seizures 3 days after blood transfusion. Brain magnetic resonance imaging (MRI) showed changes compatible with posterior reversible encephalopathy syndrome and subarachnoid hemorrhage. Magnetic resonance angiogram showed diffuse vasoconstriction of multiple cerebral arteries. The second patient was a 9-year-old boy who presented with severe thunderclap headaches. Brain MRI showed isolated intraventricular hemorrhage. Computed tomography/MR angiogram and digital subtraction angiogram were normal. A week later, he developed focal neurological deficits. Repeated MR angiogram showed diffuse vasospasm of multiple intracranial arteries. Both children recovered completely. A clinico-radiological review of previously reported childhood RCVS is provided.

scholarly journals Histopathological evaluation of most frequent liver diseases in cats

2009 ◽  
Vol 63 (1-2) ◽  
pp. 103-112 ◽  
Author(s):  
Branislav Kureljusic ◽  
Darko Marinkovic ◽  
Jelena Obadovic ◽  
Milena Djordjevic ◽  
Vladimir Kukolj
Keyword(s):  
Liver Diseases ◽  
Histological Analysis ◽  
Final Diagnosis ◽  
Clinical Findings ◽  
Histological Changes ◽  
Histopathological Evaluation ◽  
Precise Diagnosis ◽  
Close Cooperation ◽  
The University ◽  
Age And Sex

Histological analysis was performed on the liver of 27 cats of different breeds, age and sex, autopsied at the Department of Pathological Morphology of the Faculty of Veterinary Medicine of the University of Belgrade, and findings showed lymphoplasmocytic cholangiohepatitis, different degrees of fibrosis, passive hyperemia, fatty changes, cholestase, and neoplasms. The mentioned entities occurred very rarely as individual morphological manifestations, because the liver has different functions so that one morphological change often causes others to follow. Thus, for example, fibrosis was often followed by intrahepatic cholestase. Histopathological evaluation of liver disease is important not only in the autopsied samples, but also in diagnostics of liver diseases, in samples obtained by biopsy, which is important for making a precise diagnosis. The interpretation of the established histological changes in the liver requires close cooperation between clinicians and pathologists, because the final diagnosis is made on the grounds of morphological, biochemical and clinical findings.

scholarly journals Histopathologic interpersonal overview of generalized pustular cutaneous reaction to Hydroxychloroquine (HCQ): New challenging clinical manifestation

2021 ◽  
Vol 15 (6) ◽  
pp. 2102-2106
Author(s):  
Alireza Ghanadan ◽  
Zahra Naraghi ◽  
Kambiz Kamyab- Hesari ◽  
Azita Nikoo ◽  
Zahra Halaji ◽  
...  
Keyword(s):  
Clinical Judgment ◽  
Lymphocytic Infiltration ◽  
Final Diagnosis ◽  
Pustular Psoriasis ◽  
Cutaneous Eruption ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Clinical Presentations ◽  
Diagnostic Report ◽  
Exanthematous Pustulosis ◽  
Pathology Review

Background: Pathologic examination of Acute Generalized Exanthematous Pustulosis (AGEP) and Pustular Psoriasis (PP) are similar. We encountered many patients with PP or AGEP who cannot be distinguished clinically, pathologically and based on disease course from each so we designed a comprehensive interpersonal histopathologic overview of these patients' samples. Method: Histopathological data of 16 patients over 3.5 years were analyzed. Four pathologists separately reviewed specimens based on eighteen criteria (9 Epidermal and 9 Dermal). Severity score for each criterion was considered as to be (0 to 3+). We compared the final pathologic diagnosis with primary one. Results: Neutrophilic and lymphocytic infiltration in dermis were seen in all cases of AGEP while intraepithelial pustules. Subcorneal and intraepithelial pustules, spongiosis, neutrophilic exocytosis, neutrophilic and lymphocytic infiltration in dermis were observed in all cases of PP. The most severe neutrophilic inflammation; acanthosis and neutrophilic or lymphocytic infiltration were seen in PP. The authors of this study have been reported generalized pustular clinical presentations of patients have been taken HCQ, and in the recent pandemic it is also one of the concerns that many studies have been focused (....). Conclusion: When primary histopathologic report is AGEP/PP overlap, clinical judgment is the best way to manage and it is more probable that the final diagnosis being PP. When only AGEP or PP is histopathologic diagnostic report, it is usually enough to make final diagnosis and appropriate management. Key words: hydroxychloroquine, HCQ, generalized pustular cutaneous eruption, Pustular Psoriasis (PP), Acute Generalized Exanthematous Pustulosism, AGEP, Histopathological overview, pathology, review

scholarly journals Neurosyphilis Presenting as Asymptomatic Optic Perineuritis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Sarah E. Parker ◽  
John H. Pula
Keyword(s):  
White Cell Count ◽  
Brain Mri ◽  
Transmitted Disease ◽  
The United States ◽  
Opening Pressure ◽  
Disc Edema ◽  
Sexually Transmitted ◽  
Nerve Sheath ◽  
Clinical Presentations ◽  
Ocular Disorders

Introduction. Syphilis is a sexually transmitted disease that is known as “the great imitator” due to its wide variety of clinical presentations, including ocular disorders. There has been an increase in the rate of syphilis in the United States, especially in persons with HIV. We report a case of optic perineuritis in an asymptomatic male secondary to central nervous system (CNS) syphilis.Case Report. A 41-year-old man was found to have bilateral disc edema on a routine exam. Brain MRI was unremarkable, and lumbar puncture revealed a normal opening pressure, with an elevated cerebrospinal fluid white cell count. Orbit MRI showed optic nerve sheath expansion and enhancement, consistent with optic perineuritis. He tested positive for syphilis based on serum RPR and FTA-ABS.Conclusion. Ophthalmologic findings, including disc edema, may be the presenting features of CNS syphilis. Even in asymptomatic persons, perineuritis should be considered early, as diagnosis and treatment are imperative given the progressive nature of the disease.

Microsurgical Resection of Craniocervical Dermoid Cyst by Far Lateral Approach: Case Report and Literature Review

2018 ◽  
Vol 37 (04) ◽  
pp. 339-342
Author(s):  
Lucas Meguins ◽  
Antonio Spotti ◽  
Dionei Morais ◽  
Carlos Rocha ◽  
Ricardo Caramanti ◽  
...  
Keyword(s):  
Case Report ◽  
Dermoid Cyst ◽  
Posterior Fossa ◽  
Symptom Control ◽  
Lateral Approach ◽  
Neurological Deficits ◽  
Uneventful Recovery ◽  
Far Lateral Approach ◽  
Far Lateral ◽  
Posterior Fossa Dermoid

Introduction Intracranial dermoid tumors represent a rare clinical entity that accounts for 0.04 to 0.6% of all intracranial tumors. Their location in the posterior fossa is uncommon. Objectives To report the case of a young woman with a posterior fossa dermoid cyst treated by right far lateral approach. Case Report A 17-year-old woman presenting with swallowing difficulties for 6 weeks was referred for a neurological investigation. A magnetic resonance imaging (MRI) scan showed a hyperintense T1-weighted large expansive lesion occupying the posterior fossa and compressing the anterior face of the brain stem and cerebellum. The patient underwent surgical treatment by right far lateral approach with decompression of vascular and neural structures. The patient presented an uneventful recovery, and was discharged home on the fourth postoperative day without any additional neurological deficits. The anatomopathological analysis confirmed the diagnosis of dermoid cyst. Conclusion The far lateral approach is a safe and feasible route to appropriately treat large posterior fossa dermoid cysts. Decompression of vascular and neural structures is essential to achieve good symptom control.

scholarly journals Giant hyperostosis after sphenoid ridge en plaque meningioma removal

2014 ◽  
Vol 21 (4) ◽  
pp. 471-476
Author(s):  
Danil Adam ◽  
Toma Papacocea ◽  
Ioana Hornea ◽  
Cristiana Moisescu
Keyword(s):  
Brain Mri ◽  
Growth Patterns ◽  
Neurological Deficits ◽  
X Rays ◽  
Blurred Vision ◽  
Orbital Cavity ◽  
Orbital Wall ◽  
The Central Nervous System ◽  
The Right ◽  
Sphenoid Ridge

Abstract Meningioma is in most cases a benign tumor of the central nervous system with two growth patterns: en masse and en plaque. Hyperostosis is associated in 13 - 49 % of the cases with en plaque meningioma. We describe the case of a 47 years old woman with meningotelial sphenoid ridge meningioma which was totally removed. At the first admission she presented with no neurological deficits, seizures and a mild right exophthalmos. This had an indolent growth. After 10 years, the patient was readmitted for headache, blurred vision and right exophthalmos. Skull X-rays and brain MRI revealed an important thickening of the right superior orbit wall and sphenoid ridge. She underwent a new surgery. There was no intradural tumor found. Instead, bones of the superior and lateral right orbit walls were very hiperostotic. A hole of 3/2 cm in the right superior orbital wall was drilled and the orbital cavity was decompressed. In the postoperative period, the symptoms were remitted and the exophthalmos reduced. We discuss the causes and management of hyperostosis associated with meningiomas.

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