scholarly journals "Eight and a half" and "nine syndrome" rare presentation of pontine lesions; case reports and review of literature

2019 ◽  
Author(s):  
Samira Yadegari ◽  
Masoud Aghsaei-Fard ◽  
Mohammadreza Akbari ◽  
Arash Mirmohammad-Sadeghi
Keyword(s):  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Clinical Findings ◽  
Medial Longitudinal Fasciculus ◽  
Medial Lemniscus ◽  
Abducens Nucleus ◽  
Rare Presentation ◽  
Seventh Cranial Nerve ◽  
Pontine Tegmentum ◽  
Magnetic Resonance Imaging Mri

Background: Eight-and-a-half syndrome (EHS) is one-and-a-half syndrome [(conjugated horizontal gaze palsy and internuclear ophthalmoplegia (INO)] plus ipsilateral fascicular seventh cranial nerve palsy. Involvement of lower pontine tegmentum including the abducens nucleus, the ipsilateral medial longitudinal fasciculus (MLF), and the adjacent facial colliculus contribute to the clinical findings of EHS. Recently, nine syndrome with addition of hemiparesis or hemianesthesia to EHS (due to involvement of adjacent corticospinal tract or medial lemniscus) is suggested. Methods: Consecutive patients with presentation  of EHS or nine syndrome were reviewed from referral neuro-ophthalmology and strabismus clinics. Results: Three cases of EHS were identified with different etiologies of intracerebral hemorrhage (ICH), demyelination, and neuromyelitis optica spectrum disorder. Moreover, one case of "nine syndrome" due to ICH was described. Brain magnetic resonance imaging (MRI) in all of them revealed lesion in lower tegmentum of pons. Conclusion: Apart from different etiologies, recognition of EHS or nine syndrome allows precise localization of the lesion to lower pontine tegmentum ipsilaterally.

De novo convulsive status epilepticus in patients with multiple sclerosis treated with dalfampridine

2018 ◽  
Vol 25 (4) ◽  
pp. 618-621 ◽  
Author(s):  
Emilie Panicucci ◽  
Mikael Cohen ◽  
Veronique Bourg ◽  
Fanny Rocher ◽  
Pierre Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Status Epilepticus ◽  
De Novo ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Convulsive Status Epilepticus ◽  
Biological Tests ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
History Of Epilepsy

Background: Dalfampridine extended release (DAL) is a broad-spectrum voltage-gated potassium channel blocker that is indicated in multiple sclerosis to improve the nerve conduction of demyelinated axons. Seizures are a known side effect of DAL, which is contraindicated in patients with a history of epilepsy. Objective: Three cases of multiple sclerosis (MS) with de novo convulsive status epilepticus (CSE) probably related to dalfampridine administration are described. Methods: No patients had a history of seizures or renal impairment. Biological tests were normal. A brain magnetic resonance imaging (MRI) showed diffuse cortical and subcortical atrophy without active inflammatory lesions. Results: All three patients presented with CSE that was attributed to DAL and so was discontinued. Conclusion: These case reports illustrate that, aside from seizures, de novo CSE is a potential complication of MS patients treated with DAL.

scholarly journals Transient Edematous Lesions of the Splenium in Epileptic Patients

2005 ◽  
Vol 32 (3) ◽  
pp. 352-355 ◽  
Author(s):  
Giovanna Carrara ◽  
Edoardo Ferlazzo ◽  
Donatella Tampieri ◽  
Frederick Andermann ◽  
Denis Melanson
Keyword(s):  
Antiepileptic Drugs ◽  
Case Reports ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
High Signal ◽  
Focal Lesions ◽  
Epileptic Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Patients With Epilepsy

ABSTRACT:Background:Transient focal lesions in the splenium of the corpus callosum (SCC) have been previously described in patients with epilepsy or without epilepsy but receiving antiepileptic drugs (AED).Case reports:Two epileptic patients were admitted to our long-term monitoring unit. Antiepileptic drugs were completely discontinued a few days later. One patient had no seizures. The other had three attacks, the last of which occurred two days before a brain magnetic resonance imaging (MRI) was performed. In both cases brain MRI showed a lesion in the SCC characterized by high signal on T2-weighted images and no enhancement after Gadolinium infusion. The patients were discharged with their pre-admission medications. A follow-up MRI five weeks later showed resolution of the SCC lesions.Conclusions:The pathogenesis of transient SCC lesions in epileptic patients is still unclear. In our patients, either the sudden AED withdrawal or the seizures activity may be presumed to be the cause, though an individual susceptibility must also be considered.

Pregnancy luteoma: a rare presentation and expectant management

2018 ◽  
Vol 7 (2) ◽  
Author(s):  
Sinem Ayse Duru Coteli ◽  
Gokcen Orgul ◽  
Mehmet Coskun Salman
Keyword(s):  
Surgical Intervention ◽  
Hormone Secretion ◽  
Expectant Management ◽  
Clinical Findings ◽  
Resonance Imaging ◽  
Successful Management ◽  
Rare Presentation ◽  
Pathological Evaluation ◽  
Magnetic Resonance Imaging Mri

AbstractPregnancy luteoma (PL) is a rare cause of non-neoplastic masses in pregnancy. PLs are usually asymptomatic. However, general symptoms like pelvic pain, lumbalgia, constipation or virilization due to active hormone secretion can be detected as the clinical findings of these benign cysts. The definitive diagnosis of PL is most commonly possible with a pathological evaluation after surgical intervention. Therefore, we present a successful management of PL with close follow-up until delivery. Beside the suspicion of malignancy by ultrasonography and magnetic resonance imaging (MRI), the cytological evaluation of ascites revealed benign cells which was helpful to decide expectant management.

scholarly journals Primary Meningeal Rhabdomyosarcoma

Sarcoma ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Manisha Palta ◽  
Richard F. Riedel ◽  
James J. Vredenburgh ◽  
Thomas J. Cummings ◽  
Scott Green ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Medical Literature ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Radiographic Appearance ◽  
Lower Extremity Weakness ◽  
Sagittal Sinus ◽  
Word Finding ◽  
Magnetic Resonance Imaging Mri ◽  
Disseminated Disease

Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI) demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13). Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC) systemic therapy.

scholarly journals Case Report: Transient cortical blindness following coronary angiography

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 439
Author(s):  
Yudi Her Oktaviono ◽  
Maureen Victoria Kawilarang ◽  
Michael Kawilarang ◽  
Ruth Irena Gunadi ◽  
Petrina Theda Philothra ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Contrast Agent ◽  
Vision Loss ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Cortical Blindness ◽  
Post Procedure ◽  
Transient Cortical Blindness ◽  
Magnetic Resonance Imaging Mri ◽  
Catheterization Procedure

Temporary blindness, also known as transient cortical blindness, is an uncommon impediment of contrast agent usage during angiography procedures. The occurrence of blindness after a cardiac catheterization procedure is rare and its pathophysiology remains largely speculative. The most probable mechanism seems to be contrast agent-related disruption of the blood–brain barrier, possibly initiated by several predisposing factors. This case reports a 52-year-old man with transient vision loss that occurred following coronary angiography. Brain magnetic resonance imaging (MRI) showed no acute pathology and his vision spontaneously returned within approximately 15 hours post-procedure without any requirement of specific therapy. Suggesting that transient cortical blindness may have occurred following coronary angiography which subsequently self-resolved.

376 Human Connectome-Based Tractographic Atlas of the Brainstem Connections and Surgical Approaches

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 289-289
Author(s):  
Antonio Meola ◽  
Fang-Cheng Yeh ◽  
Wendy Fellows-Mayle ◽  
Jared Weed ◽  
Juan Carlos Fernandez-Miranda
Keyword(s):  
Spatial Resolution ◽  
Diffusion Mri ◽  
Diffusion Tensor ◽  
Population Based ◽  
Medial Longitudinal Fasciculus ◽  
Surgical Approaches ◽  
Medial Lemniscus ◽  
Rubrospinal Tract ◽  
Human Connectome Project ◽  
Magnetic Resonance Imaging Mri

Abstract INTRODUCTION The brainstem is one of the most challenging areas for the neuro- surgeon because of the limited space between gray matter nuclei and white matter pathways. Diffusion tensor imaging based tractography has been used to study the brainstem structure, but the angular and spatial resolution could be improved further with advanced diffusion magnetic resonance imaging (MRI). Objective: To construct a high angular/spatial resolution, wide-population based, comprehensive tractography atlas that presents an anatomical review of the surgical approaches to the brainstem. METHODS We applied advanced diffusion MRI finer tractography to a population-based atlas constructed with data from a total of 488 subjects from the Human Connectome Project-488. Five formalin-fixed brains were studied for surgical landmarks. Luxol Fast Blue stained histological sections were used to validate the results of tractography. RESULTS >We acquired the tractography of the major brainstem pathways and vali- dated them with histological analysis. The pathways included the cerebellar peduncles, corticospinal tract, corticopontine tracts, medial lemniscus, lateral lemniscus, spino- thalamic tract, rubrospinal tract, central tegmental tract, medial longitudinal fasciculus, and dorsal longitudinal fasciculus. Then, the reconstructed 3-dimensional brainstem structure was sectioned at the level of classic surgical approaches, namely supra- collicular, infracollicular, lateral mesencephalic, perioculomotor, peritrigeminal, antero- lateral (to the medulla), and retro-olivary approaches. CONCLUSION The advanced diffusion MRI fiber tracking is a powerful tool to explore the brainstem neuroanatomy and to achieve a better understanding of surgical approaches.

scholarly journals Improvement of Gait Dysfunction after Applying a Hinged Ankle–Foot Orthosis in a Hemiplegic Cerebral Palsy Patient with Disrupted Medial Lemniscus: A Case Report

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 81
Author(s):  
Su Min Son ◽  
Min Cheol Chang
Keyword(s):  
Knee Flexion ◽  
Diffusion Tensor ◽  
Therapeutic Option ◽  
Gait Pattern ◽  
Ankle Dorsiflexion ◽  
Medial Lemniscus ◽  
Abnormal Gait ◽  
Hemiplegic Cerebral Palsy ◽  
Genu Recurvatum ◽  
Magnetic Resonance Imaging Mri

We describe the successful application of hinged ankle−foot orthoses (AFOs) in a cerebral palsied (CP) patient with gait instability due to a disrupted medial lemniscus (ML). The patient was a 27-month-old male CP child with gait instability who presented with reduced knee flexion and ankle dorsiflexion, with severe genu recurvatum on his right lower extremity during gait. The patient had no motor weakness or spasticity. Conventional magnetic resonance imaging (MRI) revealed no definite abnormal lesion. However, diffusion tensor tractography (DTT) showed disruption of the left ML, consistent with right hemiplegic symptoms. The integrity of the major motor-related neural tracts, including the corticospinal and corticoreticulospinal tracts, was preserved. We considered that the patient’s abnormal gait pattern was related to the disrupted ML state. We applied hinged AFOs, which immediately resulted in a significantly stabilized gait. The angles of knee flexion and ankle dorsiflexion increased. Our findings indicate that the application of hinged AFOs could be a useful therapeutic option for CP patients with gait instability related to ML disruption. In addition, we showed that DTT is a useful tool for identifying the causative brain pathology in CP patients, especially when conventional brain MRIs show no specific lesion.

scholarly journals Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years

2021 ◽  
Vol 49 (01) ◽  
pp. 046-055
Author(s):  
Victoria Hernández ◽  
Tania Lena ◽  
Eliana Camacho ◽  
Matías Craviotto
Keyword(s):  
Glomus Tumor ◽  
Case Reports ◽  
Low Frequency ◽  
Benign Neoplasm ◽  
Surgical Excision ◽  
Soft Tissue Tumors ◽  
Glomus Tumors ◽  
The Past ◽  
Pubmed Search ◽  
Magnetic Resonance Imaging Mri

AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.

Gastric antral vascular ectasia in children, rare presentation

2020 ◽  
Vol 13 (11) ◽  
pp. e236896
Author(s):  
Matthew Pizzuto ◽  
Sarah Ellul ◽  
Mohamed Shoukry
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Abdominal Ultrasound ◽  
Clinical Findings ◽  
Evidence Based ◽  
Gastric Antral Vascular Ectasia ◽  
Perianal Area ◽  
Rare Presentation ◽  
Vascular Ectasia ◽  
Blood Tests ◽  
Abdominal Examination

A 14-year-old boy, a known case of perinatal hypoxic cerebral palsy, presented to paediatric emergency with acute melaena and blood staining around feeding gastrostomy site. Physical examination revealed pallor, but no signs of distress with an unremarkable abdominal examination. Routine blood tests revealed normochromic. Abdominal ultrasound scan and Meckel’s scan were unremarkable. The patient underwent examination under anaesthesia of the perianal area and joint upper and lower gastrointestinal endoscopy. Streak-like gastritis with no signs of active bleeding lesions were noted and patchy areas of colitis involving the descending and sigmoid colon and the rectum. All clinical findings and evidence-based diagnosis matched gastric antral vascular ectasia. He was successfully managed conservatively with elemental hydrolysed feeding formula.

scholarly journals Identifying a Common Functional Framework for Apathy Large-Scale Brain Network

2021 ◽  
Vol 11 (7) ◽  
pp. 679
Author(s):  
Vincenzo Alfano ◽  
Mariachiara Longarzo ◽  
Giulia Mele ◽  
Marcello Esposito ◽  
Marco Aiello ◽  
...  
Keyword(s):  
Large Scale ◽  
Brain Magnetic Resonance Imaging ◽  
Brain Network ◽  
Neural Pathways ◽  
Resonance Imaging ◽  
Daily Life Activities ◽  
Functional Differences ◽  
Central Gyrus ◽  
Magnetic Resonance Imaging Mri ◽  
Disease Specific

Apathy is a neuropsychiatric condition characterized by reduced motivation, initiative, and interest in daily life activities, and it is commonly reported in several neurodegenerative disorders. The study aims to investigate large-scale brain networks involved in apathy syndrome in patients with frontotemporal dementia (FTD) and Parkinson’s disease (PD) compared to a group of healthy controls (HC). The study sample includes a total of 60 subjects: 20 apathetic FTD and PD patients, 20 non apathetic FTD and PD patients, and 20 HC matched for age. Two disease-specific apathy-evaluation scales were used to measure the presence of apathy in FTD and PD patients; in the same day, a 3T brain magnetic resonance imaging (MRI) with structural and resting-state functional (fMRI) sequences was acquired. Differences in functional connectivity (FC) were assessed between apathetic and non-apathetic patients with and without primary clinical diagnosis revealed, using a whole-brain, seed-to-seed approach. A significant hypoconnectivity between apathetic patients (both FTD and PD) and HC was detected between left planum polare and both right pre- or post-central gyrus. Finally, to investigate whether such neural alterations were due to the underlying neurodegenerative pathology, we replicated the analysis by considering two independent patients’ samples (i.e., non-apathetic PD and FTD). In these groups, functional differences were no longer detected. These alterations may subtend the involvement of neural pathways implicated in a specific reduction of information/elaboration processing and motor outcome in apathetic patients.

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