scholarly journals Intraventricular tuberculosis abscess in an immunocompromised patient: clinical vignette

2021 ◽  
Vol 15 (6) ◽  
pp. 293-297
Author(s):  
Mohamad Hanafiah ◽  
Shahizon A Mohamed Mukhari ◽  
Aida M Mustapha ◽  
Nazimah Ab Mumin
Keyword(s):  
Polymerase Chain Reaction Analysis ◽  
External Ventricular Drainage ◽  
Tuberculous Infection ◽  
High Grade Fever ◽  
Hyperintense Signal ◽  
Tuberculous Abscess ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
Hypointense Signal ◽  
The Right

Abstract Tuberculosis is caused by Mycobacterium tuberculosis. Tuberculosis of the central nervous system is common and manifestations include meningeal and intraparenchymal diseases. However, intraventricular tuberculous abscess is a rare manifestation of intracranial tuberculous infection. We present a case of an immunocompromised female patient with high-grade fever and signs of meningism. The computed tomography and magnetic resonance imaging (MRI) of the brain showed hydrocephalus with rim-enhancing lesion in the right lateral ventricle. The MRI demonstrated a hypointense signal on T1-weighted imaging, hyperintense signal on T2-weighted imaging, and mild restricted diffusion in diffusion-weighted imaging. She underwent emergency external ventricular drainage and frank pus was drained. Diagnosis of tuberculosis was made via polymerase chain reaction analysis and culture. Understanding the intracranial manifestation of neurotuberculosis is imperative to arrive at the diagnosis correctly and ensure prompt treatment.

scholarly journals Wallerian-Like Degeneration After Ischemic Stroke Revealed by Diffusion - Weighted Imaging

2007 ◽  
Vol 34 (2) ◽  
pp. 243-244 ◽  
Author(s):  
P. N. Sylaja ◽  
M. Goyal ◽  
T. Watson ◽  
M. D. Hill
Keyword(s):  
Cerebral Artery ◽  
Diffusion Weighted Imaging ◽  
Acute Onset ◽  
Cerebral Peduncle ◽  
Diffusion Weighted ◽  
Intravenous Tissue Plasminogen Activator ◽  
Hyperintense Signal ◽  
Apparent Diffusion ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

A 22-year-old female was seen in the emergency within one hour of acute onset of right sided headache followed by weakness of the left side of body. On neurological examination, she was mildly drowsy, had forced right gaze deviation, dysarthria, left hemiplegia and left hemisensory loss. Computed tomography (CT) scan revealed early ischemic changes in the right middle cerebral artery (MCA) territory. The CT angiography done showed evidence of dissection of the supraclinoid segment of the right internal carotid artery with reduced flow distally into the MCA, which was confirmed by a conventional angiogram. In view of the intracranial carotid dissection, the patient was not treated with intravenous tissue plasminogen activator. Magnetic resonance imaging (MRI) of the brain done on the next day revealed evidence of acute ischemic lesions in the right MCA and anterior cerebral artery territory on diffusion-weighted imaging (DWI), with normal brainstem. [Figure 1] A repeat MRI performed 13 days after ictus showed hyperintense signal on DWI in the right cerebral peduncle which was hypointense on apparent diffusion coefficient (ADC) map suggestive of Wallerian-like degeneration. [Figure 2] The signal changes were less conspicuous on T2-weighted images. She had antigravity strength in the left leg but remained weak in her left arm at one month.

scholarly journals COVID-19–Associated Acute Asymmetric Hemorrhagic Necrotizing Encephalopathy: A Case Report

2022 ◽  
pp. 194187442110553
Author(s):  
Najo Jomaa ◽  
Tarek El Halabi ◽  
Jawad Melhem ◽  
Georgette Dib ◽  
Youssef Ghosn ◽  
...  
Keyword(s):  
Neurological Complications ◽  
Parahippocampal Gyrus ◽  
Biological Drugs ◽  
Acute Necrotizing Encephalopathy ◽  
Immune Mediated ◽  
Acute Necrotizing ◽  
History Of ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Background: Coronavirus disease 2019 (COVID-19) has been associated with many neurological complications affecting the central nervous system. Purpose: Our aim was to describe a case of COVID-19 associated with a probable variant of acute necrotizing encephalopathy (ANE). Results: A 60-year-old man who presented with a 3-day history of dyspnea, fever, and cough tested positive for severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2). Five days following his admission, the patient was intubated secondary to respiratory failure. Following his extubation 16 days later, he was found to have a left-sided weakness. Magnetic resonance imaging (MRI) of the brain showed hemorrhagic rim-enhancing lesions involving the right thalamus, left hippocampus, and left parahippocampal gyrus. These lesions showed decreased relative cerebral blood flow on MR perfusion and restricted on diffusion-weighted imaging. These neuroimaging findings were consistent with ANE. The left-sided weakness gradually improved over the subsequent weeks. Conclusions: We concluded that COVID-19 can be associated with ANE, a condition believed to be the result of an immune-mediated process with activation of the innate immune system. Future studies must address whether biological drugs targeting the pro-inflammatory cytokines could prevent the development of this condition.

scholarly journals Sequential ACTH and catecholamine secretion in a phaeochromocytoma

2002 ◽  
pp. 201-206 ◽  
Author(s):  
PS van Dam ◽  
A van Gils ◽  
MR Canninga-van Dijk ◽  
EJ de Koning ◽  
LJ Hofland ◽  
...  
Keyword(s):  
Severe Hypertension ◽  
Catecholamine Secretion ◽  
Surgical Removal ◽  
Ectopic Acth ◽  
Hyperintense Signal ◽  
Ectopic Acth Production ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
T2 Weighted Images

OBJECTIVE: We describe a patient with an ACTH-producing phaeochromocytoma who initially presented with hypercortisolism and normal catecholamine concentrations, followed by near-normalisation of ACTH secretion and massive catecholamine secretion. In vitro studies were carried out on the tumour to evaluate the interaction between the tumour cells and normal adrenal cortex. METHODS AND RESULTS: A 30-year-old man initially presented with severe hypercortisolism, biochemical evidence of ectopic ACTH production, a tumour in the right adrenal gland without a hyperintense signal on the T2-weighted images at magnetic resonance imaging (MRI) scanning, and normal urinary metanephrine concentrations. After 6 months, ACTH production had almost completely resolved, but the patient developed severe hypertension and excess catecholamines. At repeated MRI-scanning, the T2-weighted images showed a hyperintense signal, in agreement with the diagnosis of phaeochromocytoma. Although the initial T1-weighted images suggested bleeding in the adrenal tumour, no signs of bleeding were observed after surgical removal. The diagnosis of ACTH-producing phaeochromocytoma was histologically and immunohistochemically confirmed. Cultured cell suspensions of the tumour secreted ACTH, which stimulated cortisol production in the ipsilateral adrenocortical cells. CONCLUSION: This case demonstrates that the biological activity of an ACTH-producing phaeochromocytoma can vary significantly in time, which may be the consequence of different stages of tumour differentiation.

scholarly journals Postpartum Seizures: Cerebral Venous Sinus Thrombosis, Case Report

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Ahmed AAH ◽  
Keyword(s):  
Magnetic Resonance ◽  
Sinus Thrombosis ◽  
Past History ◽  
Good Condition ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
High Grade Fever ◽  
Venous Sinus Thrombosis ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Cerebral venous sinus thrombosis is of rarity during pregnancy, and it is included in the differential diagnosis of a woman presenting with seizures during pregnancy and puerperium. Here we report a case of young lady who developed Cerebral Venous Sinus Thrombosis (CVST) 6 days after delivery, presented with a chief complain of loss of consciousness and high grade fever with recent past history of severe occipital headache and generalized convulsions, which progressed into left sided weakness. Magnetic Resonance Imaging (MRI) / Magnetic Resonance Venography (MRV) demonstrated filling defects at the right transverse and sigmoid sinuses. The patient was started on Enoxaparin and warfarin. The patient kept on improving gradually and was discharged after 24 days in a good condition.

scholarly journals Involvement of peripheral III nerve in multiple sclerosis patient: Report of a new case and discussion of the underlying mechanism

2017 ◽  
Vol 23 (5) ◽  
pp. 748-750 ◽  
Author(s):  
Natalia Shor ◽  
Maria del Mar Amador ◽  
Didier Dormont ◽  
Catherine Lubetzki ◽  
Anne Bertrand
Keyword(s):  
Multiple Sclerosis ◽  
Peripheral Nerve ◽  
Cranial Nerves ◽  
Underlying Mechanism ◽  
Secondary Process ◽  
Peripheral Nerve Damage ◽  
History Of ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Multiple sclerosis (MS) is a chronic disorder that affects the central nervous system myelin. However, a few radiological cases have documented an involvement of peripheral cranial nerves, within the subarachnoid space, in MS patients. We report the case of a 36-year-old female with a history of relapsing-remitting (RR) MS who consulted for a subacute complete paralysis of the right III nerve. Magnetic resonance imaging (MRI) examination showed enhancement and thickening of the cisternal right III nerve, in continuity with a linear, mesencephalic, acute demyelinating lesion. Radiological involvement of the cisternal part of III nerve has been reported only once in MS patients. Radiological involvement of the cisternal part of V nerve occurs more frequently, in almost 3% of MS patients. In both situations, the presence of a central demyelinating lesion, in continuity with the enhancement of the peripheral nerve, suggests that peripheral nerve damage is a secondary process, rather than a primary target of demyelination.

scholarly journals COT-05 A CASE OF NEPALESE IN JAPAN SUSPECTED OF NEUROCYSTICERCOSIS

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii41-ii41
Author(s):  
Masataka Mikai ◽  
Ryo Matsuzaki ◽  
Chie Matsuura ◽  
Sayaka Terazono ◽  
Shumpei Ando ◽  
...  
Keyword(s):  
Tissue Reaction ◽  
Whole Body ◽  
High Signal ◽  
Enhancement Effect ◽  
Pathological Findings ◽  
Whole Body Ct ◽  
Pathological Result ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract INTRODUCTION Cystosis is the most common parasitic disease of the central nervous system. Especially in developing countries, it is one of the differential diagnosis of diseases that cause seizures. We report a case of a foreigner suspected of having neurocysticercosis. CASE A 36-year-old Nepalese visiting Japan for 2 years. Two days ago, she lost consciousness for a few seconds and was transferred to our hospital complaint of convulsions for about 1 minute. Head Computed Tomography (CT) revealed a mass lesion with a ring enhancement effect of about 10 mm in the right frontal lobe, with edema around it. Magnetic Resonance Imaging (MRI) shows T1WI low signal, T2WI high signal, and diffusion-weighted image with a light high signal. The ring-shaped enhancement effect was exhibited. Whole body CT showed no obvious lesions and blood tumor markers were negative. Various infections were negative, and cerebrospinal fluid cytology and culture were negative. POSTOPERATIVE COURSE From the surgical findings, brain abscesses such as cerebral tuberculoma were suspected, but various tests were negative. As a pathological result, the tumor had a capsule, and the inside showed necrotic tissue and fibrous granulation tissue reaction. There were no insects, and no obvious cells were identified by special staining. From the origin area, symptoms, and pathological findings, neurocysticercosis was most suspected. CONCLUSION We experienced a case of suspected neurocysticercosis that was difficult to diagnose from images and pathological findings. In neurocysticercosis, when the worm body dies, contrast-enhanced MRI shows a ring-like enhancement effect, and it is accompanied by surrounding edema, which may require differentiation from brain tumors.

scholarly journals Facial Palsy, Hypoacusis and Vertigo as Inaugural Symptoms of Neuroborreliosis - Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 323-327
Author(s):  
JB da Costa
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Facial Palsy ◽  
Cranial Nerves ◽  
Cranial Neuropathy ◽  
Common Causes ◽  
Oral Corticosteroids ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Introduction: Facial Palsy (FP) is the most common acute mononeuropathy and consists of a decrease in facial muscle strength due to facial nerve damage. Peripheral FP (PFP) can result from a wide variety of disorders and aetiologies, with Lyme Disease (LD) being considered one of the most common causes of FP. LD is an infectious disease that affects the central nervous system, causing Neuroborreliosis (NB) in 15% of cases. Cranial neuropathy is the most common form of presentation of NB, as uni or bilateral PFP. We describe a case of PFP with hypoacusis and vertigo as the inaugural presentation of neuroborreliosis. Case Report: We present a case report of a 75-year-old female patient, referred to ENT consultation due to a 3-day course of a grade 4 right PFP, moderate right sensorineural hearing loss and right vestibular hypofunction. The patient underwent cranioencephalic Computed Tomography (CT-CE) which excluded a central event and was treated with 2 cycles of oral corticosteroids, without any clinical improvement. A Magnetic Resonance Imaging (MRI) was performed, which showed an abnormal inflammatory uptake of the right facial nerve. An analytical positivity for Borrelia IgM was found and the diagnosis of polyneuropathic NB with involvement of the VII and VIII right cranial pairs was assumed. The patient completed 28 days of doxycycline, with FP and vertigo improvement and normalization of hearing acuity. Discussion/Conclusion: In the presented case, the absence of the classical migratory erythema or painful meningopolyneuritis didn’t exclude the diagnosis of NB. FP associated to signs of other cranial nerves involvement raised the hypothesis of a systemic polyneuropathic disease, which motivated the etiological investigation carried out.

scholarly journals Intraparenchymal Hemorrhage due to Brain Metastasis of Hepatocellular Carcinoma

2017 ◽  
Vol 11 (3) ◽  
pp. 516-525 ◽  
Author(s):  
Rafael Sartori Balbinot ◽  
Ana Laura Facco Muscope ◽  
Mateus Dal Castel ◽  
Silvana Sartori Balbinot ◽  
Raul Angelo Balbinot ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Brain Metastasis ◽  
Cranial Computed Tomography ◽  
Left Hemiparesis ◽  
Intraparenchymal Hemorrhage ◽  
Axial Mass ◽  
The Central Nervous System ◽  
Extrahepatic Metastases ◽  
Hypointense Signal ◽  
The Right

Although extrahepatic metastases from hepatocellular carcinoma (HCC) are present in only 5–15% of cases, they are certainly factors associated with poor prognosis. The main sites include lung, lymph nodes, bones, and adrenal glands, in descending order. Metastasis in the central nervous system is extremely rare, and the incidences vary from 0.6 to 1.7%. We report a case of a 54-year-old man previously diagnosed with alcohol-induced cirrhosis of the liver and HCC. The patient was admitted presenting progressive left hemiparesis and headache which started 2 days earlier, with no history of cranioencephalic trauma. After admission, cranial computed tomography revealed an intraparenchymal hemorrhage area with surrounding edema in the right frontal lobe. An angioresonance requested showed a large extra-axial mass lesion located in the right frontal region with well-defined contours and predominantly hypointense signal on T2 sequence. At first, the radiological findings suggested meningioma as the first diagnostic hypothesis. However, the patient underwent surgery. The tumor was completely removed, and the morphological and immunohistochemical findings were consistent with metastatic hepatocarcinoma associated with meningioma. In postoperative care, the patient did not recover from the left hemiparesis and manifested Broca’s aphasia. He had a survival time of 24 weeks, presenting acute liver failure as his cause of death. There is a lack of evidence supporting a specific management of patients with brain metastasis from HCC. Furthermore, there are no studies that evaluate different modalities of therapeutics in brain metastasis of HCC due to the rarity of this condition. Therefore, management must be individualized depending on probable prognostic factors in these patients.

scholarly journals Neuroparacoccidioidomycosis: Case Report and Literature Review

2018 ◽  
Vol 37 (02) ◽  
pp. 134-139
Author(s):  
Marcus Morais ◽  
Sérgio Georgeto ◽  
Marcelo Haddad ◽  
José Amorim ◽  
Luis Scaliante ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Paracoccidioides Brasiliensis ◽  
Perilesional Edema ◽  
Mri Scans ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Head Computed Tomography

Introduction Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis, and it can compromise the central nervous system (CNS) in 10–27% of all cases. Case Report A 31-year-old man presented to the Emergency Department with headache, left-sided weakness, clonus at the ankle and a positive Babinski sign. Head computed tomography (CT) and magnetic resonance imaging (MRI) scans showed a 5.1 × 3.8 cm lobulated lesion with areas of liquefaction in the right centrum semiovale. Discussion Central nervous system PCM can mimic a brain tumor, and most cases are diagnosed by biopsy of the lesion. The treatment includes antibiotics, but some cases require surgery. Conclusion Due to high morbimortality rates, the diagnosis must be considered, and early treatment started in patients who live in rural regions endemic for PCM when a ring-enhancing mass associated with perilesional edema is observed on MRI scans.

scholarly journals Beyond Oncological Hyperthermia: Physically Drivable Magnetic Nanobubbles as Novel Multipurpose Theranostic Carriers in the Central Nervous System

Molecules ◽  
2020 ◽  
Vol 25 (9) ◽  
pp. 2104 ◽  
Author(s):  
Eleonora Ficiarà ◽  
Shoeb Anwar Ansari ◽  
Monica Argenziano ◽  
Luigi Cangemi ◽  
Chiara Monge ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Tumors ◽  
Ad Hoc ◽  
Superparamagnetic Iron Oxide ◽  
Conventional Radiotherapy ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Magnetic Oxygen-Loaded Nanobubbles (MOLNBs), manufactured by adding Superparamagnetic Iron Oxide Nanoparticles (SPIONs) on the surface of polymeric nanobubbles, are investigated as theranostic carriers for delivering oxygen and chemotherapy to brain tumors. Physicochemical and cyto-toxicological properties and in vitro internalization by human brain microvascular endothelial cells as well as the motion of MOLNBs in a static magnetic field were investigated. MOLNBs are safe oxygen-loaded vectors able to overcome the brain membranes and drivable through the Central Nervous System (CNS) to deliver their cargoes to specific sites of interest. In addition, MOLNBs are monitorable either via Magnetic Resonance Imaging (MRI) or Ultrasound (US) sonography. MOLNBs can find application in targeting brain tumors since they can enhance conventional radiotherapy and deliver chemotherapy being driven by ad hoc tailored magnetic fields under MRI and/or US monitoring.

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