scholarly journals Porencephalic Cyst in an Adult - A Rare Pathology

2021 ◽  
Vol 10 (12) ◽  
pp. 918-919
Author(s):  
Shreya Tapadia ◽  
Suresh Vasant Phatak ◽  
Harshith Gowda K.B ◽  
Asish Pavanan
Keyword(s):  
Cerebrospinal Fluid ◽  
White Matter ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Sudden Onset ◽  
Brain Parenchyma ◽  
Motor Deficits ◽  
Cystic Degeneration ◽  
Lateral Side ◽  
Porencephalic Cyst

Porencephalic cyst is a rare entity in adults with limited cases reported so far. It is usually congenital and seen in neonates. Here, we report a 25-year-old male who presented with post-ictal confusion following an episode of sudden onset of generalised tonic clonic seizure. He was diagnosed to have large cerebrospinal fluid (CSF) density cystic lesion in the right parieto-occipital region communicating with occipital horn on right side side of porencephaly. Porencephaly is an uncommon congenital disorder that occurs due to cystic degeneration and encephalomalacia leading to porencephalic cyst formation.1 They are considered to occur most commonly from focal encephalomalacia due to a localised cerebral insult during early gestation, 2 while the other aetiologies include trauma, infection, antenatal intraparenchymal haemorrhage and perinatal cerebral ischemia.3 If the insult occurs in late third trimester it can lead to gliosis. Porencephalic cysts are typically lined by white matter of brain parenchyma.2 They differ widely in their location and size while the clinical manifestations and presentations range from being asymptomatic to extremely impaired mental function. Generally, the signs and symptoms of porencephaly become apparent in the first year of life. The earliest manifestation being spasticity and seizures. As the age increases there is a delay in development of milestones presenting as language impairment, disability in intellect and motor deficits. Clinically head circumference measurement varies from being normal or small to an enlarged head in cases of synechiae formation that creates a one-way valve effect leading to progressive enlargement of the cyst and expansion of skull or there may be hydrocephalus.4 Radiologically the diagnosis depends on demonstrating a well-defined CSF-filled space occupying lesion lined by white matter and communicating with ventricles on computed tomography (CT) scan or magnetic resonance imaging (MRI) of brain. The prognosis of porencephaly depends on the location and extent of the cyst.5 If the cyst is very large it can cause mass effect in the form of scalloping of adjacent bone, buckling of brain parenchyma, midline shift to contra lateral side and hydrocephalus. On MRI, brain cyst appears well defined and lined by white matter with or without gliosis. Cerebrospinal fluid is the content which is shown as hypointense on T1 and hyperintense on T2.

scholarly journals Quantitative T1 mapping under precisely controlled graded hyperoxia at 7T

2016 ◽  
Vol 37 (4) ◽  
pp. 1461-1469 ◽  
Author(s):  
Alex A Bhogal ◽  
Jeroen CW Siero ◽  
Jaco Zwanenburg ◽  
Peter R Luijten ◽  
Marielle EP Philippens ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
White Matter ◽  
T1 Mapping ◽  
Brain Parenchyma ◽  
Arterial Oxygen ◽  
Longitudinal Magnetization ◽  
Fluid Content ◽  
T1 Relaxation ◽  
End Tidal ◽  
Induced Changes

Increasing the concentration of oxygen dissolved in water is known to increase the recovery rate (R1 = 1/T1) of longitudinal magnetization (T1 relaxation). Direct T1 changes in response to precise hyperoxic gas challenges have not yet been quantified and the actual effect of increasing arterial oxygen concentration on the T1 of brain parenchyma remains unclear. The aim of this work was to use quantitative T1 mapping to measure tissue T1 changes in response to precisely targeted hyperoxic respiratory challenges ranging from baseline end-tidal oxygen (PetO2) to approximately 500 mmHg. We did not observe measureable T1 changes in either gray matter or white matter parenchymal tissue. The T1 of peripheral cerebrospinal fluid located within the sulci, however, was reduced as a function of PetO2. No significant T1 changes were observed in the ventricular cerebrospinal fluid under hyperoxia. Our results indicate that care should be taken to distinguish actual T1 changes from those which may be related to partial volume effects with cerebrospinal fluid, or regions with increased fluid content such as edema when examining hyperoxia-induced changes in T1 using methods based on T1-weighted imaging.

scholarly journals The value of histopathological diagnosis in rupoid psoriasis accompanied by fever. A case report and a review of the literature

2014 ◽  
Vol 60 (6) ◽  
pp. 282-284
Author(s):  
S.H. Morariu ◽  
M.A. Badea ◽  
M.D. Vartolomei ◽  
Iudita Maria Badea ◽  
O.S. Cotoi
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Local Therapy ◽  
Signs And Symptoms ◽  
Daily Practice ◽  
Sudden Onset ◽  
Histopathological Diagnosis ◽  
Intermittent Fever ◽  
Immunosuppressed Patients ◽  
Clinical Signs And Symptoms

Abstract Psoriasis is a common dermatosis, however the rupoid type is considered as an exceptional form of this disease. Rupoid scabs are very rare in dermatological daily practice, usually being seen as secondary to syphilis in immunosuppressed patients. Rupoid psoriasis is characterized by thick and multilayered crusts that are resistant to local therapy and present a sudden onset. Severe arthropathy is a common manifestation. We did not found in literature any association of rupoid psoriasis with intermittent fever. We present the case of a patient who exhibited a rush of rupoid boards with severe arthralgia accompanied by intermittent fever. The suspicion of malignant syphilis was raised considering the clinical signs and symptoms and the specific social context of STDs. This suspicion was unconfirmed by TPHA negative reaction and histopathological appearance that showed changes typical of psoriasis. Clinical manifestations were successfully controlled with methotrexate.

scholarly journals Intracranial Hemorrhage from Dural Arteriovenous Fistulas: What Can We Find with CT Angiography?

Tomography ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 804-814
Author(s):  
Alberto Negro ◽  
Francesco Somma ◽  
Valeria Piscitelli ◽  
Giuseppe Maria Ernesto La Tessa ◽  
Carmine Sicignano ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Intracranial Hemorrhage ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Diagnostic Technique ◽  
Signs And Symptoms ◽  
Sudden Onset ◽  
Arteriovenous Fistulas ◽  
Common Location ◽  
Dural Arteriovenous Fistulas

(1) Background: Dural arteriovenous fistulas (DAVF) represent a rare acquired intracranial vascular malformation, with a variety of clinical signs and symptoms, which make their diagnosis difficult. Intracranial hemorrhage is one of the most serious clinical manifestations. In this paper the authors’ goal was to verify the accuracy and utility of contrast-enhanced brain CT angiography (CTA) for the identification and the characterization of dural arteriovenous fistulas (DAVFs) in patients who presented with brain hemorrhage compared to 3D digital subtraction angiography (3D DSA); (2) a retrospective study of 26 patients with DAVFs who presented with intracranial hemorrhage to our institution was performed. The information reviewed included clinical presentation, location and size of hemorrhage, brain CTA and 3D DSA findings; (3) results: 61% (16/26) of DAVFs were identified by CTA. The vast majority of patients were male (69%, 18/26) and the most common presenting symptom was sudden onset headache. All DAVFs had cortical venous drainage and about one-third were associated with a venous varix. The most common location was tentorial (73%, 19/26); (4) conclusions: CTA can represent a valid alternative diagnostic method to 3D DSA for the study of DAVF in the initial and preliminary diagnostic approach, especially in emergency situations. In fact, it represents a fast, inexpensive, non-invasive and above all, easily accessible and available diagnostic technique, unlike DSA or MRI, allowing to provide information necessary for the identification, classification and treatment planning of DAVFs.

scholarly journals A Cluster of Neurobrucellosis at King Hussein Medical Center, Jordan - A Comprehensive Analysis And Review.

2020 ◽  
pp. 349-358
Author(s):  
Al Dhomour Aktham ◽  
Al Shyyab Awni ◽  
Al Etan Shaher ◽  
Al Adamat Mohammed ◽  
Amin Bani Salamah ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Medical Center ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Close Monitoring ◽  
Animal Products ◽  
Fluid Analysis ◽  
Clinical Presentations ◽  
Low Glucose

In this retrospective review, we describe the neurological clinical manifestations in five cases diagnosed with neurobrucellosis over two years between 2018 and 2020, and the application of different proposed criteria for establishing the diagnosis and treatment of neurobrucellosis. All cases were confirmed to have brucellosis with laboratory tests, and all were living in Jordan, which is considered part of a highly endemic area within the Middle East. The neurobrucellosis proposed criteria was applied, which requires signs and symptoms consistent with neurobrucellosis, presence of anti-Brucella antibodies in cerebrospinal fluid and serum with or without isolation of Brucella species in CSF and serum, cerebrospinal fluid analysis shows: lymphocytosis, high protein level, and low glucose level and radiological findings on MRI or CT. In all five cases, we have confirmed direct contact with animals or animal products either as a consumer or as a farmworker. Their signs and symptoms were consistent with brucellosis. In all cases, haematological and CSF results, in addition to imaging findings using magnetic resonance and computed tomography, were highly coherent with neurobrucellosis. Neurobrucellosis can present with different clinical manifestations, either as a sole site of infection like acute or subacute meningitis or myelitis, or in context of a multi variable systemic disease. In patients with unusual neurological clinical presentations, and those with persistent chronic symptoms like headache, malaise, or depression, neurobrucellosis should be highly suspected, especially in endemic areas. Such patients must have a prolonged course of antibiotics between 6 to 18 months with close monitoring of their serum and CSF examination

scholarly journals T cell acute lymphoblastic leukaemia presenting with sudden onset right oculomotor nerve palsy with normal neuroradiography and cerebrospinal fluid studies

2012 ◽  
Vol 2012 (mar26 1) ◽  
pp. bcr0120125685-bcr0120125685
Author(s):  
V. R. Bhatt ◽  
M. Naqi ◽  
R. Bartaula ◽  
S. Murukutla ◽  
S. Misra ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
T Cell ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Nerve Palsy ◽  
Sudden Onset ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy

scholarly journals Mapping of long-term cognitive and motor deficits in pediatric cerebellar brain tumor survivors into a cerebellar white matter atlas

2021 ◽  
Author(s):  
Frederik Grosse ◽  
Stefan Mark Rueckriegel ◽  
Ulrich-Wilhelm Thomale ◽  
Pablo Hernáiz Driever
Keyword(s):  
Brain Tumor ◽  
Executive Function ◽  
Cognitive Function ◽  
White Matter ◽  
Cerebellar Nuclei ◽  
Motor Deficits ◽  
Deep Cerebellar Nuclei ◽  
Cerebellar White Matter ◽  
Lesion Symptom Mapping

Abstract Purpose Diaschisis of cerebrocerebellar loops contributes to cognitive and motor deficits in pediatric cerebellar brain tumor survivors. We used a cerebellar white matter atlas and hypothesized that lesion symptom mapping may reveal the critical lesions of cerebellar tracts. Methods We examined 31 long-term survivors of pediatric posterior fossa tumors (13 pilocytic astrocytoma, 18 medulloblastoma). Patients underwent neuronal imaging, examination for ataxia, fine motor and cognitive function, planning abilities, and executive function. Individual consolidated cerebellar lesions were drawn manually onto patients’ individual MRI and normalized into Montreal Neurologic Institute (MNI) space for further analysis with voxel-based lesion symptom mapping. Results Lesion symptom mapping linked deficits of motor function to the superior cerebellar peduncle (SCP), deep cerebellar nuclei (interposed nucleus (IN), fastigial nucleus (FN), ventromedial dentate nucleus (DN)), and inferior vermis (VIIIa, VIIIb, IX, X). Statistical maps of deficits of intelligence and executive function mapped with minor variations to the same cerebellar structures. Conclusion We identified lesions to the SCP next to deep cerebellar nuclei as critical for limiting both motor and cognitive function in pediatric cerebellar tumor survivors. Future strategies safeguarding motor and cognitive function will have to identify patients preoperatively at risk for damage to these critical structures and adapt multimodal therapeutic options accordingly.

scholarly journals Neuralgic amyotrophy: an underrecognized entity

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110065
Author(s):  
Tae Uk Kim ◽  
Min Cheol Chang
Keyword(s):  
Clinical Practice ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Clinical History ◽  
Cervical Radiculopathy ◽  
Sudden Onset ◽  
Clinical Findings ◽  
Magnetic Resonance Neurography ◽  
Essential Information ◽  
Neuralgic Amyotrophy

Neuralgic amyotrophy (NA) is markedly underdiagnosed in clinical practice, and its actual incidence rate is about 1 per 1000 per year. In the current article, we provide an overview of essential information about NA, including the etiology, clinical manifestations, diagnostic investigations, differential diagnosis, treatment, and prognosis. The causes of NA are multifactorial and include immunological, mechanical, or genetic factors. Typical clinical findings are a sudden onset of pain in the shoulder region, followed by patchy flaccid paralysis of muscles in the shoulder and/or arm. A diagnosis of NA is based on a patient’s clinical history and physical examination. Gadolinium-enhanced magnetic resonance imaging and high-resolution magnetic resonance neurography are useful for confirming the diagnosis and choosing the appropriate treatment. However, before a diagnosis of NA is confirmed, other disorders with similar symptoms, such as cervical radiculopathy or rotator cuff tear, need to be ruled out. The prognosis of NA depends on the degree of axonal damage. In conclusion, many patients with motor weakness and pain are encountered in clinical practice, and some of these patients will exhibit NA. It is important that clinicians understand the key features of this disorder to avoid misdiagnosis.

scholarly journals Retrospective analysis of the clinical presentation and imaging of eight primary benign mediastinal schwannomas

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ramiro Sandoval-Macias ◽  
Irving Daniel Ortiz-Sanchez ◽  
Ana Lilia Remirez-Castellanos ◽  
Luis Mora-Hernandez ◽  
Candelaria Cordova-Uscanga ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Signs And Symptoms ◽  
Cystic Degeneration ◽  
Imaging Features ◽  
Posterolateral Thoracotomy ◽  
Accurate Analysis ◽  
Cystic Changes ◽  
History Of ◽  
Histology And Immunohistochemistry

Abstract Objective Mediastinal schwannomas are sometimes confused with other neoplasms during initial radiological studies, especially when there is a history of cancer in another area. In these cases, a more accurate analysis using computed tomography (CT) or even magnetic resonance (MRI) is required. Our study aimed to perform a retrospective analysis of the clinical and imaging features for a series of patients with mediastinal schwannomas that were confirmed by histology and immunohistochemistry. Results We found eight patients, five men and three women, with an average age of 51 years for this study. The main signs and symptoms at diagnosis were chest pain, dyspnea, cough, and dysphagia. CT showed that the tumor was located in the posterior compartment of the chest in 7/8 cases. Tumors > 10 cm were more heterogeneous and showed cystic changes. All patients underwent posterolateral thoracotomy, and radiological follow-up showed no evidence of recurrence. Histological analysis was considered the gold standard to confirm diagnosis, along with at least one neurogenic IHC marker. In conclusion, mediastinal schwannomas are benign encapsulated tumors. According to CT, schwannomas > 10 cm show cystic degeneration more frequently. Posterolateral thoracotomy allows complete resection and is considered the surgical approach of choice.

Increased Cerebrospinal Fluid Glycine: A Biochemical Marker for a Leukoencephalopathy With Vanishing White Matter

1999 ◽  
Vol 14 (11) ◽  
pp. 728-731 ◽  
Author(s):  
Marjo S. van der Knaap ◽  
Ron A. Wevers ◽  
Shigeo Kure ◽  
Fons J. M. Gabreëls ◽  
Nanda M. Verhoeven ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
White Matter ◽  
Biochemical Marker ◽  
Vanishing White Matter

scholarly journals The Potential Roles of Blood–Brain Barrier and Blood–Cerebrospinal Fluid Barrier in Maintaining Brain Manganese Homeostasis

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1833
Author(s):  
Shannon Morgan McCabe ◽  
Ningning Zhao
Keyword(s):  
Cerebrospinal Fluid ◽  
Blood Brain Barrier ◽  
Blood Circulation ◽  
Critical Role ◽  
Systemic Circulation ◽  
Brain Parenchyma ◽  
Brain Barrier ◽  
Blood Brain ◽  
The Brain

Manganese (Mn) is a trace nutrient necessary for life but becomes neurotoxic at high concentrations in the brain. The brain is a “privileged” organ that is separated from systemic blood circulation mainly by two barriers. Endothelial cells within the brain form tight junctions and act as the blood–brain barrier (BBB), which physically separates circulating blood from the brain parenchyma. Between the blood and the cerebrospinal fluid (CSF) is the choroid plexus (CP), which is a tissue that acts as the blood–CSF barrier (BCB). Pharmaceuticals, proteins, and metals in the systemic circulation are unable to reach the brain and spinal cord unless transported through either of the two brain barriers. The BBB and the BCB consist of tightly connected cells that fulfill the critical role of neuroprotection and control the exchange of materials between the brain environment and blood circulation. Many recent publications provide insights into Mn transport in vivo or in cell models. In this review, we will focus on the current research regarding Mn metabolism in the brain and discuss the potential roles of the BBB and BCB in maintaining brain Mn homeostasis.

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