scholarly journals Stroke-like migraine attacks after radiation therapy syndrome: Case report and review of the literature

2017 ◽  
Vol 30 (6) ◽  
pp. 568-573 ◽  
Author(s):  
Achint K Singh ◽  
Bundhit Tantiwongkosi ◽  
Anna-Marieta Moise ◽  
Wilson B Altmeyer
Keyword(s):  
Radiation Therapy ◽  
Vision Loss ◽  
Rare Complication ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Brain Irradiation ◽  
Contrast Enhanced ◽  
Delayed Complication ◽  
Brain Radiation ◽  
The Brain

A 26-year-old female presented with vision loss accompanied by migraine-like headaches. A contrast-enhanced magnetic resonance imaging of the brain was performed which revealed findings suggestive of stroke-like migraine attacks after radiation therapy (SMART) syndrome. SMART syndrome is a delayed complication of brain radiation characterized by neurologic symptoms including migraine-like headaches, seizures, and hemispheric impairment. The purpose of this article is to make the readers aware of this rare complication of brain irradiation. Appropriate diagnosis of SMART syndrome is essential to avoid invasive tests.

scholarly journals Adjuvant hypofractionated partial-brain radiation therapy for pediatric Ewing sarcoma brain metastases: case report

2016 ◽  
Vol 17 (4) ◽  
pp. 434-438 ◽  
Author(s):  
Ritchell van Dams ◽  
Henry S. Park ◽  
Ahmed K. Alomari ◽  
Adele S. Ricciardi ◽  
Harini Rao ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Case Report ◽  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Symptomatic Treatment ◽  
Reasonable Approach ◽  
Inflammatory Changes ◽  
Brain Radiation ◽  
The Brain

This case report demonstrates that hypofractionated partial-brain radiation therapy with limited margins is a reasonable approach following gross tumor resection of Ewing sarcoma metastases to the brain. The patient presented with 2 intracranial metastases treated with gross-total resection followed by radiation therapy to 30 Gy in 5 fractions. The patient experienced symptomatic treatment-related inflammatory changes with resolution after receiving dexamethasone. He remains alive at 21 months of follow-up with no evidence of disease.

Rapidly progressive vision loss due to fulminant idiopathic intracranial hypertension: a diagnostic and management dilemma

2020 ◽  
Vol 13 (11) ◽  
pp. e236188
Author(s):  
Jagadeesh Sutraye ◽  
Mohan Kannam ◽  
Rajat Kapoor ◽  
Virender Sachdeva
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Vision Loss ◽  
Obese Woman ◽  
Visual Fields ◽  
Csf Analysis ◽  
Contrast Enhanced ◽  
Grade Ii ◽  
The Right ◽  
The Brain

A 44-year-old obese woman presented with decrease in vision in the right eye (RE) for 3 days. She reported a simultaneous onset of holocranial headache that worsened on bending forward. She denied eye pain, pain on eye movements, and other ocular or neurological complaints. On examination, her distance best-corrected visual acuity was counting fingers at 1 m in the RE and 20/20 in the left eye (LE). Colour vision was subnormal in both eyes (BE). There was grade II relative afferent pupillary defect in the RE. Fundus examination showed disc oedema in BE . Visual fields in the LE showed central scotoma extending nasally. A provisional diagnosis of papillitis was considered. However, contrast-enhanced MRI of the brain and orbits showed evidence of elevated intracranial pressure. Cerebrospinal fluid (CSF) opening pressure was 42 cm H2O while rest of the CSF analysis was normal. Diagnosis was revised to fulminant idiopathic intracranial hypertension. Management with medical therapy and urgent thecoperiteoneal shunt improved visual function in BE.

Aspergillus meningitis and discitis from low-back procedures in an immunocompetent patient

2007 ◽  
Vol 48 (6) ◽  
pp. 687-689 ◽  
Author(s):  
A. B. Larson Kolbe ◽  
A. M. McKinney ◽  
A. Tuba Karagulle Kendi ◽  
D. Misselt
Keyword(s):  
Steroid Injection ◽  
Rare Complication ◽  
Immunocompetent Patient ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Epidural Steroid ◽  
The Brain

We present a case of an immunocompetent patient who developed Aspergillus meningitis, subsequent to discitis, presumed to be from an epidural steroid injection. Magnetic resonance imaging (MRI) of the lumbar spine confirmed the diagnosis of discitis. Fluoroscopic-guided aspiration of the disc showed growth of Aspergillus fumigatus. MRI of the brain revealed involvement of the right third cranial nerve. Repeat MRIs demonstrated multiple leptomeningeal masses consistent with granulomatous meningitis. Meningitis is a rare complication of discitis, discogram, or epidural steroid injection. Aspergillus usually only infects immunocompromised patients, but rarely can affect immunocompetent patients.

Contrast Enhanced Magnetic Resonance Imaging of the Brain Using Gadolinium-DTPA

1987 ◽  
Vol 28 (6) ◽  
pp. 659-665 ◽  
Author(s):  
J. Valk ◽  
R. G. M. de Slegte ◽  
F. C. Crezee ◽  
G. J. Hazenberg ◽  
S. I. Thjaha ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Gadolinium Dtpa ◽  
Contrast Enhanced ◽  
The Brain

scholarly journals Intraventricular neurocysticercosis: 18 consecutive patients and review of the literature

2002 ◽  
Vol 12 (6) ◽  
pp. 1-7 ◽  
Author(s):  
Albert C. Cuetter ◽  
Russell J. Andrews
Keyword(s):  
Clinical Presentation ◽  
Case Series ◽  
Surgical Removal ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Fatal Disease ◽  
Effective Manner ◽  
Noncommunicating Hydrocephalus ◽  
The Brain ◽  
Prompt Diagnosis

Object The prognosis for intraventricular neurocysticercosis (IVNCC) is poorer than that for parenchymal NCC, making prompt diagnosis and treatment especially important. Although active, viable intraventricular cysts produce no reaction in the host; they can cause noncommunicating hydrocephalus, the onset of which is frequently abrupt. With the death of the larva comes a local granulomatous ependymitis, generalized ventriculitis, and meningoencephalitis. The authors report on 18 patients with IVNCC (accrued from a larger case series of 62 patients with NCC treated over an 11-year period), detailing clinical presentation, neuroimaging findings, treatment, and outcome. Methods All patients presented with hydrocephalus and/or meningitis. The most valuable diagnostic tests were magnetic resonance imaging of the brain and EITB of serum and/or cerebrospinal fluid. Treatment included albenda-zole and steroid therapy in all cases, and when necessary in cases requiring urgent or emergency ventriculostomy and/or surgical removal of the obstructing cyst (followed by shunt placement if indicated). Conclusions An extensive review of the literature on IVNCC has been prepared, with the goal of providing the reader with the information necessary to diagnose and treat this complex and potentially fatal disease in a timely and effective manner.

Brain Metastasis from Nonseminomatous Germ Cell Tumors of the Testis: Case Report and Review of the Role of Surgery

Neurosurgery ◽  
1989 ◽  
Vol 25 (5) ◽  
pp. 814-819 ◽  
Author(s):  
Richard K. Jelsma ◽  
Michael Carroll
Keyword(s):  
Radiation Therapy ◽  
Brain Metastasis ◽  
Germ Cell ◽  
Cell Tumor ◽  
Nonseminomatous Germ Cell Tumor ◽  
Whole Brain Radiation ◽  
Large Brain ◽  
Surgical Debulking ◽  
Brain Radiation ◽  
The Brain

Abstract The prognosis for patients with nonseminomatous germ cell tumor of the testis is good, even when extensive metastatic disease is present, because this tumor is very sensitive to chemotherapy with cisplatin, vinblastine, and bleomycin (PVB). If a metastasis occurs in the brain, however, the prognosis is poor because the blood-brain barrier limits the entrance of these drugs into the brain and creates a sanctuary for tumor. The current treatment for a brain metastasis is either standard PVB chemotherapy plus whole brain radiation therapy or a rigorous chemotheraputic regimen that penetrates the blood-brain barrier better than PVB. Surgery is seldom used for brain metastasis, largely because of the poor results with surgical debulking in noncentral nervous system disease. This is the report of a patient with disseminated nonseminomatous germ cell tumor and multiple large brain metastases, who was treated with surgery, PVB, and whole brain radiation therapy and cured. Evidence is presented to support a role for surgical debulking in patients with large brain metastasis.

scholarly journals Spontaneous epidural pneumorrhachis in 14 years old

2021 ◽  
Vol 12 ◽  
pp. 329
Author(s):  
Joseph Scott Hudson ◽  
Seung Jeong ◽  
Xiaoran Zhang ◽  
Taylor J. Abel
Keyword(s):  
Rare Complication ◽  
Case Description ◽  
Subdural Space ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
History Of ◽  
Unclear Etiology ◽  
Epidural Gas ◽  
Spontaneous Onset ◽  
Rule Out

Background: Pneumorrhachis is an exceedingly rare complication of pneumomediastinum as air tracks through tissue planes into the epidural (or subdural space). The majority of these patients present with a clear history of trauma, iatrogenic injury, pneumothorax, vomiting, or retching. Case Description: A 14-year-old male presented with the asymptomatic spontaneous onset of pneumorrhachis associated with significant pneumomediastinum of unclear etiology. Conclusion: Most patients with pneumorrhachis present with nonfocal neurological examinations. For these patients, it is critical to rule out infection as the cause of epidural gas. If other systemic signs are present, then urgent contrast-enhanced magnetic resonance imaging should be obtained. The majority of patients will demonstrate spontaneous radiographic resolution of pneumorrhachis within several days.

scholarly journals Magnetic resonance imaging of the cranial nerves in congenital, traumatic, and vascular diseases: a pictorial essay

2021 ◽  
Vol 54 (3) ◽  
pp. 185-192 ◽  
Author(s):  
Mariana Dalaqua ◽  
Felipe Barjud Pereira do Nascimento ◽  
Larissa Kaori Miura ◽  
Fabiano Reis ◽  
Márcio Ricardo Taveira Garcia ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cranial Nerves ◽  
Three Dimensional ◽  
Vascular Diseases ◽  
Resonance Imaging ◽  
Complex Anatomy ◽  
Contrast Enhanced ◽  
Pictorial Essay ◽  
The Brain

Abstract The cranial nerves, which represent extensions of the functional structures of the brain, traverse the head and neck. They are connected to various cranial structures and are associated with several diseases. An in-depth understanding of their complex anatomy and normal imaging appearance allows the examiner to identify and characterize abnormalities with greater precision. One important tool for evaluating the cranial nerves is contrast-enhanced magnetic resonance imaging, especially three-dimensional steady-state free precession sequences, which provide high soft-tissue and spatial resolution, despite the slenderness of the nerves. In most cases, imaging findings are nonspecific. Therefore, to narrow the differential diagnosis, it is necessary to take a full patient anamnesis, perform a focused physical examination and order laboratory tests. In this pictorial essay we review, illustrate and discuss, from a pathophysiological perspective, congenital, traumatic, and vascular diseases of the cranial nerves.

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