scholarly journals Giant tumefactive perivascular spaces in a pediatric patient: A rare radiological entity

2021 ◽  
Vol 12 ◽  
pp. 613
Author(s):  
Mohammad Hamza Bajwa ◽  
Mohammad Yousuf Ul Islam ◽  
Fatima Mubarak
Keyword(s):  
Diffusion Weighted Imaging ◽  
Pediatric Population ◽  
Accurate Diagnosis ◽  
Perivascular Spaces ◽  
Occipital Region ◽  
Resonance Imaging ◽  
Diffusion Restriction ◽  
Perilesional Edema ◽  
Inversion Recovery Imaging ◽  
Fluid Attenuated Inversion Recovery

Background: Giant tumefactive perivascular spaces (TPVS) are radiological rarities and may mimic other neurological structural lesions. Fewer than 80 cases have been reported in the literature with even fewer in the pediatric population. Case Description: The authors present an image report showcasing a 3-year-old boy presenting with uncontrolled seizures despite multiple anti-epileptic medications. His magnetic resonance imaging showed multiple, non-contrast enhancing cyst clusters within the left parieto-occipital region that was hyperintense on T2-weighted imaging, and isointense to cerebrospinal fluid. Due to a characteristic absence of perilesional edema seen on fluid-attenuated inversion recovery imaging or diffusion restriction on diffusion-weighted imaging (DWI) sequences, this was diagnosed as a giant TPVS. Conclusion: Accurate diagnosis of these rare radiological entities is based on pathognomonic findings that can help prevent unnecessary surgery and guide management for patients, particularly in the pediatric population as seen in our case.

scholarly journals Marchiafava-Bignami disease with hyperintensity on late diffusion-weighted imaging

2014 ◽  
Vol 3 (7) ◽  
pp. 204798161454328 ◽  
Author(s):  
Takayasu Iwai ◽  
Koushun Matsuo ◽  
Fukiko Morii-Kitani ◽  
Fumiko Azuma ◽  
Hisayasu Matsuo ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Diffusion Weighted Imaging ◽  
Resonance Imaging ◽  
Inversion Recovery Imaging ◽  
Diffusion Weighted ◽  
Temporary Treatment ◽  
Fluid Attenuated Inversion Recovery ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Methods Of Treatment

A 69-year-old man with a decades-long history of chronic alcohol consumption was admitted with gait disturbance (short steps and spasticity), deterioration of activity, and stuporous consciousness. Head magnetic resonance imaging (MRI) revealed hyperintensity on fluid-attenuated inversion recovery imaging in the corpus callosum and frontal white matter. The lesion later became more apparent on diffusion-weighted imaging. The clinical diagnosis was Marchiafava-Bignami disease (MBD). As temporary treatment, refraining from alcohol consumption and administration of vitamins were prescribed. The condition of the patient gradually improved. The purposes of this study were to demonstrate the clinical and radiological variety of MBD and to identify practical methods of treatment of this pathology.

scholarly journals Intracranial dural chondroma in a child—conventional and advanced neuroimaging characteristics and differential diagnosis

2017 ◽  
Vol 31 (4) ◽  
pp. 386-389 ◽  
Author(s):  
Shai Shrot ◽  
Alan R Cohen ◽  
Fausto J Rodriguez ◽  
Frank Berkowitz ◽  
Bruno P Soares ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diffusion Weighted Imaging ◽  
Pediatric Population ◽  
Resonance Imaging ◽  
Focal Lesions ◽  
Diagnostic Significance ◽  
High Apparent Diffusion Coefficient ◽  
Apparent Diffusion ◽  
Additional Imaging ◽  
Adc Values

Intracranial chondromas are rare tumors, especially in the pediatric population. We describe the conventional and advanced neuroimaging characteristics of this rare convexity dura-based chondroma in a young adolescent. In particular we demonstrate that diffusion-weighted imaging (DWI) facilitates differentiation between a dura-based chondroma and the more frequent classical meningioma. Chondromas are typically DWI hypointense with high apparent diffusion coefficient (ADC) values while meningiomas are typically DWI hyperintense with low ADC values. We also discuss the relevant additional differential diagnoses of dura based focal lesions for the pediatric population as well as the diagnostic significance of additional imaging modalities, including computed tomography, magnetic resonance imaging and cerebral angiography.

Conventional and advanced MR imaging findings in a cohort of pathology-proven dermoid cysts of the pediatric scalp and skull

2021 ◽  
pp. 197140092110591
Author(s):  
Bettina L Serrallach ◽  
Gunes Orman ◽  
M John Hicks ◽  
Nilesh Desai ◽  
Stephen Kralik ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diffusion Weighted Imaging ◽  
Pediatric Population ◽  
Imaging Findings ◽  
Anterior Fontanelle ◽  
Resonance Imaging ◽  
Close Proximity ◽  
Rim Enhancement ◽  
Age Range ◽  
Mr Characteristics

Background In the pediatric population, dermoid cysts are among the most frequent lesions of the scalp and skull. Imaging plays a key role in characterizing scalp and skull lesions in order to narrow the differential diagnoses. In general, dermoids are described as heterogeneous T1-/T2-hypo- to hyperintense lesions on magnetic resonance imaging. Methods The goal of this retrospective study is to evaluate the diffusion weighted imaging findings while reviewing the conventional T1-/T2-/T1+C-weighted MR characteristics in a pathology-proven series of 14 dermoids of the pediatric scalp and skull. Results In our pediatric cohort (eight boys, six girls, age range 3–95 months), half of the dermoids were homogeneous T1-hypointense and homogeneous T2-hyperintense. We found a mixture of restricted (45.5%) and increased diffusion (54.5%) in dermoids. The vast majority of dermoids (91.7%) showed rim enhancement. Most dermoids (57.1%) were located at the midline and adjacent to one of its sutures. Conclusions This study suggests that dermoids may have more variable imaging appearances than hitherto assumed and are frequently seen in close proximity or adjacent to the anterior fontanelle.

DWI-FLAIR Mismatch-guided IVT is Safe and Effective in Treatment of AIS Beyond 4.5 Hours

2020 ◽  
Vol 3 (2) ◽  
pp. 81-87
Author(s):  
Pawan T. Ojha ◽  
Shashank Nagendra ◽  
Shripad S. Pujari ◽  
Rakesh K. Singh ◽  
Rakesh Shyam Lalla ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Diffusion Weighted Imaging ◽  
National Institutes Of Health ◽  
Modified Rankin Scale ◽  
Resonance Imaging ◽  
Nihss Score ◽  
Fluid Attenuated Inversion Recovery ◽  
Magnetic Resonance Imaging Mri

Background: Perfusion or clinical mismatch imaging is useful in selecting patients with acute ischemic stroke (AIS) for reperfusion therapies beyond 4.5 hours. These techniques are expensive, technically difficult, and therefore unavailable in most settings. The diffusion weighted imaging-fluid attenuated inversion recovery (DWI-FLAIR) mismatch pattern has been studied only in wake-up stroke/stroke with unclear time of onset but not in AIS patients with clear time of onset of more than 4.5 hours. This study assesses routinely available magnetic resonance imaging (MRI) DWI-FLAIR sequences for selecting AIS patients for intravenous thrombolytic therapy (IVT) beyond 4.5 hours of the witnessed onset of symptoms. Aim: To study the clinical spectrum and outcome of patients with AIS who received IVT based on the DWI-FLAIR mismatch seen beyond 4.5 hours of symptom onset. Methods, Observation, and Results: Retrospective analysis was performed on 10 patients who received IVT for AIS beyond 4.5 hours and had an MRI DWI-FLAIR mismatch. In cohort study, 60% patients were males, with the median age of 59 years, the median baseline National Institutes of Health Stroke Scale (NIHSS) score of 10 (range 7 to 15), and the median time from the onset to imaging of 412.5 minutes. Within 24 hours of thrombolysis, improvement of >4 points in NIHSS was seen in 7 out of 10 (70%) patients, and at the modified Rankin scale, the score of 0 to 1 was noted at 3 months in 8 out of 10 (80%) patients. Neuroimaging at 24 hours showed no intracerebral bleed. Discussion and Conclusion: DWI-FLAIR mismatch-guided IVT is safe and effective in patients with AIS beyond 4.5 hours of the onset of symptoms. More studies are recommended to confirm these findings.

scholarly journals Residual cholesteatoma of the mastoid cavity presenting with radiologic signal of a cholesterol granuloma: A case report

2018 ◽  
Vol 4 (2) ◽  
pp. 21
Author(s):  
Marilyn Isabel ◽  
Jean Chénard ◽  
Margaret Aron
Keyword(s):  
Temporal Bone ◽  
Diffusion Weighted Imaging ◽  
Mastoid Cavity ◽  
Cholesterol Granuloma ◽  
Resonance Imaging ◽  
Surgical Exploration ◽  
Diffusion Restriction ◽  
Recent Onset ◽  
Appropriate Treatment ◽  
Magnetic Resonance Imaging Mri

Introduction: Cholesteatoma and cholesterol granuloma can both occur in the temporal bone. Their distinct magnetic resonance imaging (MRI) signals are generally used to help differentiate one from the other to plan appropriate treatment, which differs based on the pathology.Case presentation: We present a patient with recent-onset facial paralysis whose mastoid cavity was filled with tissue radiologically resembling cholesterol granuloma but that turned out to be cholesteatoma upon surgical exploration. Complete disease extirpation was thus completed rather than simple marsupialization, the latter of which would have been sufficient in the case of cholesterol granuloma.Discussion: Cholesteatoma, although usually hypointense on T1-weighted imaging (T1WI) MRI, hyperintense on T2-weighted imaging (T2WI) MRI and showing diffusion restriction on diffusion-weighted imaging can occasionally present with an atypical MRI signal, for example, one suggestive of cholesterol granuloma.Conclusions: The clinician should keep in mind the possible diagnosis of cholesteatoma despite an atypical MRI signal in the temporal bone.

Evaluation of possible prognostic factors of fulminant acute disseminated encephalomyelitis (ADEM) on magnetic resonance imaging with fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging

2009 ◽  
Vol 50 (3) ◽  
pp. 334-339 ◽  
Author(s):  
F. Y. Donmez ◽  
H. Aslan ◽  
M. Coskun
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Diffusion Weighted Imaging ◽  
Vasogenic Edema ◽  
Acute Disseminated Encephalomyelitis ◽  
Cortical Blindness ◽  
Inversion Recovery ◽  
Resonance Imaging ◽  
Fluid Attenuated Inversion Recovery

Background: Acute disseminated encephalomyelitis (ADEM) may be a rapidly progressive disease with different clinical outcomes. Purpose: To investigate the radiological findings of fulminant ADEM on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) images, and to correlate these findings with clinical outcome. Material and Methods: Initial and follow-up magnetic resonance imaging (MRI) scans in eight patients were retrospectively evaluated for distribution of lesions on FLAIR images and presence of hemorrhage or contrast enhancement. DWI of the patients was evaluated as to cytotoxic versus vasogenic edema. The clinical records were analyzed, and MRI results and clinical outcome were correlated. Results: Four of the eight patients died, three had full recovery, and one had residual cortical blindness. The distribution of the hyperintense lesions on FLAIR sequence was as follows: frontal (37.5%), parietal (50%), temporal (37.5%), occipital (62.5%), basal ganglia (50%), pons (37.5%), mesencephalon (37.5%), and cerebellum (50%). Three of the patients who died had brainstem involvement. Two patients had a cytotoxic edema, one of whom died, and the other developed cortical blindness. Six patients had vasogenic edema: three of these patients had a rapid progression to coma and died; three of them recovered. Conclusion: DWI is not always helpful for evaluating the evolution or predicting the outcome of ADEM. However, extension of the lesions, particularly brainstem involvement, may have an influence on the prognosis.

scholarly journals Bilateral hearing loss as an initial presentation of Creutzfeldt-Jakob disease

2021 ◽  
Vol 15 (4) ◽  
pp. 548-549
Author(s):  
Janaina Mariana de Araujo Miranda Brito-Marques ◽  
Eduardo Sousa de Melo ◽  
Fabíola Lys de Medeiros ◽  
Cristiano Sobral de Carvalho ◽  
Paulo Roberto de Brito-Marques
Keyword(s):  
Hearing Loss ◽  
Diffusion Weighted Imaging ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Cerebellar Syndrome ◽  
Bilateral Hearing Loss ◽  
Apparent Diffusion ◽  
Fluid Attenuated Inversion Recovery ◽  
Jakob Disease ◽  
The Brain

ABSTRACT. We reported a case of a 61-year-old male patient with anacusis, cerebellar syndrome, myoclonus, and frontal signs. The brain magnetic resonance imaging showed bilateral striated hyperintensity of the fluid-attenuated inversion recovery and restricted diffusion in the diffusion-weighted imaging and hypointense areas corresponding to the apparent diffusion coefficient in the cerebral cortex. The autopsy revealed positive immunohistochemistry for the PrPSc protein. Creutzfeldt–Jakob disease presenting with hearing loss is unusual.

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