Intracranial Cisternal Lipoma Associated with Cerebellar Cortical Dysplasia Diagnosed Using Dixon Technique: A Case Report and a Review of Literature

Background: Intracranial lipomas are sporadic congenital malformations. Previous studies have shown various brain anomalies related to intracranial lipomas, most of which are agenesis or dysgenesis of the adjacent structures. To the best of our knowledge, cortical dysplasia related to intracranial lipoma has yet to be reported. Case Report: We present a rare case of intracranial lipoma in the quadrigeminal and superior cerebellar cisterns with combined cerebellar cortical dysplasia. A 43-year-old female underwent brain MRI to identify possible causes of headache. We made a confident diagnosis based on MR findings using Dixon technique, which is a fat-water separation method based on chemical shift. We also identified unique combined abnormalities of the right cerebellar hemisphere near the cisternal lipoma that showed an abnormal vertical orientation of the cerebellar folia and disorganized parenchymal pattern. Conclusion: This case exhibits the rareness of the intracranial lipoma related cerebellar cortical dysplasia by reviewing relevant literature and also highlights the usefulness of Dixon techniques in daily clinical practice.

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Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0039-1677855 ◽

2019 ◽

Vol 80 (S 03) ◽

pp. S310-S310

Author(s):

Frederick Luke Hitti ◽

John Y.K. Lee

Keyword(s):

Cerebellopontine Angle ◽

Brain Mri ◽

Cranial Nerves ◽

Vascular Supply ◽

Retrosigmoid Approach ◽

Tumor Capsule ◽

Imaging Characteristics ◽

Adjacent Structures ◽

Patient Reported ◽

The Right

A variety of lesions may arise within the cerebellopontine angle (CPA). Schwannomas and meningiomas are most commonly found in this location. Imaging characteristics of meningiomas include hyperdensity on head computed tomography (CT) and avid contrast enhancement on T1-weighted postcontrast magnetic resonance imaging (MRI). Here, we present the case of a 49-year-old woman with enlarging right CPA meningioma. The patient reported mild hearing loss on the right but her neurological exam was otherwise benign. Since the lesion was enlarging and symptomatic, the patient was offered resection of the mass for diagnosis and treatment via an endoscopic retrosigmoid approach. We provide a video that illustrates the steps taken to resect this mass endoscopically. After cerebrospinal fluid (CSF) was drained to achieve brain relaxation, the tumor was visualized. The tumor had a rich vascular supply and had the appearance of a typical meningioma. The bipolar was used to cauterize the tumor's vascular supply. The tumor capsule was then opened with the microscissors. The round knife, suction, and ultrasonic tissue debrider were used to debulk the tumor. After internal debulking of the tumor, the capsule was dissected off the cerebellum and mobilized. A combination of blunt and sharp dissection was done to free the tumor capsule from the adjacent structures. Inferiorly, the lower cranial nerves were visualized. Tissue pathology confirmed a diagnosis of grade I meningioma. A gross total resection was achieved and the patient remained neurologically stable, postoperatively. Furthermore, T1-weighted postcontrast brain MRI, 1 year after surgery, showed no residual.The link to the video can be found at: https://youtu.be/X9c_inLp-So.

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Oculocerebrocutaneous Syndrome (Delleman Syndrome): A Case with a Novel Presentation of Orbital Involvement

Case Reports in Pediatrics ◽

10.1155/2021/5524131 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Mahbobeh Bahmani ◽

Razieh Naseri ◽

Alireza Iraniparast ◽

Raya Mokhtari ◽

Seyed Hamed Jafari

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Brain Mri ◽

Cerebellar Hemisphere ◽

Solid Mass ◽

Resonance Imaging ◽

Orbital Cavity ◽

Orbital Content ◽

Pediatric Neurologist ◽

The Right

Oculocerebrocutaneous syndrome (OCCS), also known as Delleman syndrome (DS), is a rare congenital anomaly featuring focal skin defects, orbital anomalies, and central nervous system malformations. Diagnosis of Delleman syndrome is based on the triad of eye, central nervous system (CNS), and cutaneous defects and confirmed by magnetic resonance imaging. A 23-day-old girl was referred to our department for brain imaging. The infant had multiple cutaneous appendages on the right side of her face. There also was a fleshy mass measuring about 12 mm over her right eye. Brain MRI demonstrated the evidence of colpocephaly, agenesis of the corpus callosum, nodular subependymal heterotopias adjacent to the right lateral ventricle, aplasia of the cerebellar vermis, hypoplasia of the right cerebellar hemisphere, and widening of CSF space in the posterior fossa. There was also an exophytic skin lesion on her right cheek, measuring about 13 × 12 mm in size. In the orbital MRI, there was a mixed cystic solid mass measuring about 25 × 20 mm in her right orbital cavity. The orbital content was abnormal and suggestive of rudimentary orbit. Considering the findings, diagnosis of oculocerebrocutaneous syndrome (Delleman syndrome) was established for the patient. Because of the variations in orbital and CNS manifestations, all patients with clinical suspicion of DS should be assessed by brain and orbital MRI and managed by a pediatric neurologist and ophthalmologist.

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Case Report: Anti-NMDAR Encephalitis With Anti-MOG CNS Demyelination After Recurrent CNS Demyelination

Frontiers in Neurology ◽

10.3389/fneur.2021.639265 ◽

2021 ◽

Vol 12 ◽

Author(s):

Bing-Yan Ren ◽

Yi Guo ◽

Jing Han ◽

Qian Wang ◽

Zai-Wang Li

Keyword(s):

Case Report ◽

Brain Mri ◽

Clinical Manifestations ◽

Epileptic Seizures ◽

Autoimmune Disorder ◽

Pulse Therapy ◽

Nmdar Encephalitis ◽

Cns Demyelination ◽

Magnetic Resonance Imaging Mri ◽

The Right

Introduction: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis, a serious neurological autoimmune disorder caused by autoantibodies with diverse clinical manifestations, may simultaneously onset with antimyelin oligodendrocyte glycoprotein (MOG) demyelination after recurrent central nervous system (CNS) demyelination.Case Report: We present a case of anti-NMDAR encephalitis combining with anti-MOG CNS demyelination following recurrent CNS demyelination. A 38-year-old man admitted to hospital developed epileptic seizures following recurrent episodes of cross-sensory disturbance and dizziness. Magnetic resonance imaging (MRI) showed a demyelinating lesion in the right brainstem initially. Despite a good response to methylprednisolone pulse therapy at the beginning, the patient still had relapses and progression after corticosteroid reduction or withdrawal. Then brain MRI discovered new serpentine lesions involving extensive cerebral cortex on his second relapse. Repeat autoantibodies test indicated cerebrospinal fluid (CSF) NMDAR antibodies coexisted with MOG-Abs simultaneously, suggesting the diagnosis of anti-NMDAR encephalitis with anti-MOG CNS demyelination.Results: After a definite diagnosis, the patient was treated with mycophenolate mofetil (MMF) and corticosteroid. He was discharged after his symptoms ameliorated. No neurological sequels remained, and there were no effects on his activities of daily living after 6 months of immunoregulatory therapy of MMF and corticosteroid.Conclusion: For individuals with recurrent CNS demyelination, especially combining with cortical encephalitis, repeated detection of autoantibodies against AE, and demyelination in CSF/serum can be helpful to enable a definite early diagnosis. For patients who suffer from anti-NMDAR encephalitis combining with anti-MOG CNS demyelination, second-line immunotherapy is recommended when first-line treatment such as steroids, intravenous immunoglobulin G (IVIG) and plasma exchange has been proven ineffective to prevent the relapse of disease.

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Epithelioid Sarcoma-like Hemangioendothelioma a Case Report

Tumori Journal ◽

10.1177/030089160509100512 ◽

2005 ◽

Vol 91 (5) ◽

pp. 436-439 ◽

Cited By ~ 12

Author(s):

Cigdem Tokyol ◽

Nüket Uzüm ◽

Ilhami Kuru ◽

Omer Uluoglu

Keyword(s):

Case Report ◽

Relevant Literature ◽

Epithelioid Sarcoma ◽

Vascular Tumor ◽

Low Grade ◽

Rare Entity ◽

Anterior Aspect ◽

Cubital Fossa ◽

Painful Mass ◽

The Right

Seven cases of an unusual low-grade vascular tumor were reported in a recent study. Despite its similarity to epithelioid sarcoma, this tumor was termed epithelioid sarcoma-like hemangioendothelioma because of the subtle histopathological and immunohistochemical differences. Another case of this rare entity in a 70-year-old woman who suffered from a painful mass on the anterior aspect of the right cubital fossa is presented here, together with a review of the relevant literature.

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Methadone-Induced Toxic Brain Damage

Case Reports in Radiology ◽

10.1155/2013/602981 ◽

2013 ◽

Vol 2013 ◽

pp. 1-2 ◽

Cited By ~ 3

Author(s):

Jérôme Corré ◽

Jérôme Pillot ◽

Gilles Hilbert

Keyword(s):

Basal Ganglia ◽

Brain Damage ◽

Brain Mri ◽

Cerebellar Hemisphere ◽

Basal Ganglia Involvement ◽

Methadone Overdose ◽

The Right ◽

Globi Pallidi

A 29-year-old man presented with comatose after methadone intoxication. Cerebral tomography only showed cortico-subcortical hypodense signal in the right cerebellar hemisphere. Brain MRI showed a rare imaging of FLAIR and DWI hyperintensities in the two cerebellar hemispheres as well as basal ganglia (globi pallidi), compatible with methadone overdose. To our knowledge this is the first reported case of both cerebellar and basal ganglia involvement in methadone overdose.

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Posterior orbital cellulitis: case report and literature review

The Journal of Laryngology & Otology ◽

10.1017/s0022215113002181 ◽

2013 ◽

Vol 127 (11) ◽

pp. 1148-1151 ◽

Cited By ~ 3

Author(s):

K Allan ◽

H Atkinson ◽

F Agada

Keyword(s):

Case Report ◽

Relevant Literature ◽

Clinical Signs ◽

Visual Disturbance ◽

Orbital Cellulitis ◽

Sphenoid Sinusitis ◽

Intravenous Antibiotics ◽

Permanent Loss ◽

History Of ◽

The Right

AbstractIntroduction:It is rare for isolated sphenoid sinusitis to cause orbital cellulitis. We present a rare case of posterior orbital cellulitis, so caused, together with a review of the relevant literature.Case report:A 29-year-old woman presented with a 6-week history of progressive, unilateral, retro-orbital and periorbital right eye pain. On examination, the only finding was reduced visual acuity in the right eye. A computed tomography scan demonstrated right frontal and sphenoid sinus opacification. Sphenoidotomy and frontal sinus trephination were subsequently performed, following failure to respond to intravenous antibiotics. After surgery, the patient's vision returned to normal.Conclusion:Isolated sphenoid sinusitis is rare but can cause significant visual disturbance and permanent loss of vision. Vague symptoms unsupported by clinical signs at presentation are a feature of posterior orbital cellulitis. The presented case highlights the problem, and the need for a high index of clinical suspicion even in the absence of firm clinical signs, in order to prevent permanent visual loss.

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Finding on brain MRI mimicking focal cortical dysplasia in early Rasmussen's encephalitis: a case report and review

Child s Nervous System ◽

10.1007/s00381-009-0905-8 ◽

2009 ◽

Vol 25 (11) ◽

pp. 1501-1506 ◽

Cited By ~ 3

Author(s):

Kuo-Liang Chiang ◽

Tai-Tong Wong ◽

Shan-Young Kwan ◽

Ting-Rong Hsu ◽

Chung-Hao Wang ◽

...

Keyword(s):

Case Report ◽

Focal Cortical Dysplasia ◽

Brain Mri ◽

Cortical Dysplasia ◽

Rasmussen’S Encephalitis

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A Case Report of Yolk Sac Tumor in Cerebellar Hemisphere and Review of Literature

10.21203/rs.3.rs-38769/v1 ◽

2020 ◽

Author(s):

Yuting Zhang ◽

Lusheng Li ◽

Ling He

Keyword(s):

Case Report ◽

Histopathological Examination ◽

Case Reports ◽

Yolk Sac ◽

Alpha Fetoprotein ◽

Yolk Sac Tumor ◽

Cerebellar Hemisphere ◽

Review Of Literature ◽

Intracranial Germ Cell Tumor ◽

The Right

Abstract Background: Yolk sac tumor also known as endodermal sinus tumor, is a rare intracranial germ cell tumor. We reported a case of yolk sac tumor in cerebellar hemisphere, and reviewed associated literatures. The majority of tumor locations are near the midline. On review of literature, very few case reports of intracranial yolk sac tumor have been published, and there is only one case report has described a yolk sac tumor arising from the cerebellum. Case presentation: A two years old boy admitted to our hospital due to headache and unsteady gait for six days. CT and MRI demonstrated a tumor in the right cerebellar hemisphere, and the blood and cerebrospinal fluid alpha-fetoprotein were found increased. It was diagnosed as yolk sac tumor after operation comfirmed by histopathological examination. Postoperative chemotherapy was performed, and the patient suffered no tumor recurrence one year and a half after the surgery. Conclusions: The clinical characteristics and imaging diagnosis of intracranial yolk sac tumor are lack of specificity, the comfirmed diagnosis is depending on the combination of elevated alpha-fetoprotein and histopathological examination.

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Posterior fossa gangliocytoma with facial nerve invasion: case report

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2003000200022 ◽

2003 ◽

Vol 61 (2A) ◽

pp. 274-276 ◽

Cited By ~ 6

Author(s):

Andrei Koerbel ◽

Daniel Monte-Serrat Prevedello ◽

Cláudio Esteves Tatsui ◽

Luciano Pellegrino ◽

Ricardo Alexandre Hanel ◽

...

Keyword(s):

Case Report ◽

Facial Nerve ◽

Posterior Fossa ◽

Cerebellar Hemisphere ◽

Facial Paresis ◽

Direct Extension ◽

Nerve Invasion ◽

Nerve Paresis ◽

The Right ◽

Diffuse Lesion

A 5 year-old boy with a cerebellar gangliocytoma with a peripheral right facial paresis and ataxia is presented. His MRI showed a heterogenous, diffuse lesion, isointense on T1 and hyperintense on T2-weigthed sequences, involving the right cerebellar hemisphere with direct extension into the right facial nerve. The present case is the first description of a gangliocytoma with direct facial nerve invasion, as demonstrated for the facial nerve paresis and supported by MRI and surgical inspection.

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The rosette-forming glioneuronal tumor mimicked cerebral cysticercosis: a case report

Neurological Sciences ◽

10.1007/s10072-021-05199-x ◽

2021 ◽

Author(s):

Dan Zhu ◽

Ailan Cheng ◽

Nickita T. L. Benons ◽

Shuguang Chu

Keyword(s):

Case Report ◽

Brain Parenchyma ◽

World Health ◽

Cerebellar Hemisphere ◽

Glioneuronal Tumor ◽

History Of ◽

Cerebral Cysticercosis ◽

Magnetic Resonance Imaging Mri ◽

Health Organization ◽

The Right

Abstract Introduction Rosette-forming glioneuronal tumor (RGNT) is a rare variety of slow growing mixed glioneuronal tumor involving primarily fourth ventricular region. This is a comprehensive analysis of a 22-year-old woman with RGNT composed of mainly cystic components. In addition, the case showed multiple lesions located in brain parenchyma which mimicked cerebral cysticercosis. Here, we analyzed this case and listed some characteristics of RGNTs in reported literature which occurring in atypical locations for further understanding it. Case report A 22-year-old woman presented with a history of transient dizziness, nausea, and vomiting. Magnetic resonance imaging (MRI) showed multiple cystic lesions in brain parenchyma and then the patient was diagnosed with cerebral cysticercosis possibility. Empirical anti-infective therapy in addition to a follow-up post 2 weeks of MRI examination showed the lesions unchanged. Finally, a biopsy of the right cerebellar hemisphere lesions verified RGNT. Conclusion RGNT is an uncommon tumor classified as grade I glioma by World Health Organization (WHO) with slightly longer course. The imaging findings of RGNT are not specific especially in atypical areas. RGNT is rare, but we should also consider the possibility in diagnosis and differential diagnosis.

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