Involvement of the brachial plexus and its branches by cystic hygromas

Lymphatic malformations that involve the nervous system are uncommon. The authors review their experience with involvement of the brachial plexus and its branches by cystic hygromas. A retrospective review of the authors' experience with pathology of the pediatric brachial plexus revealed 4 cases involving patients with compression of this structure and its branches due to cystic hygroma. Although such cases are apparently rare, the neurosurgeon should consider malformations of the lymphatic system in the differential diagnosis of masses involving the brachial plexus and its branches.

Download Full-text

Differential diagnosis of flaccid palsy of the upper extremities in children first months after birth (Literature review)

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors18645 ◽

2021 ◽

Vol 9 (1) ◽

pp. 115-126

Author(s):

Olga E. Agranovich ◽

Galina A. Ikoeva ◽

Elena L. Gabbasova ◽

Ekaterina V. Petrova ◽

Vladimir M. Kenis ◽

...

Keyword(s):

Nervous System ◽

Differential Diagnosis ◽

Brachial Plexus ◽

Peripheral Nervous System ◽

Motor Neurons ◽

Peripheral Nerves ◽

Upper Extremities ◽

Adequate Treatment ◽

Traumatic Origin ◽

Children First

This article analyzes the literature related to flaccid paresis and paralysis of the upper extremities in children during the first months of life. This pathology is a heterogeneous group of diseases with different etiopathogenesis. There are various courses of flaccid paresis and paralysis of the upper extremities in children: damage to the spinal cord, brachial plexus, peripheral nervous system to the level of the brachial plexus, and isolated damage to peripheral nerves. According to the time of occurrence, flaccid paresis and paralysis can be divided into three groups: antenatal, intranatal, and postnatal pathology. The main mechanism of occurrence of this pathology is intranatal trauma. More rare causes of flaccid paresis and paralysis of the upper extremities are antenatal conditions of dysplastic and traumatic origin, postnatal damage to the peripheral nervous system due to trauma or infection. Congenital contractures of the upper extremities combined with flaccid paralysis are connected with genetically determined diseases of the lower motor neurons and congenital myopathies, intrauterine injuries of the brachial plexus peripheral nerves. This article discusses the issues of topical and differential diagnosis of this pathology, the clinical picture suitable for each period of the childs life, and the prognosis of the disease. This research will be useful not only for neurologists, but also for specialists of related specialties: orthopedists, physiotherapists, and neonatologists for making correct the diagnosis, providing adequate treatment, and predicting its results.

Download Full-text

Reconsidering NMIHBA Core Features: Macrocephaly Is Not a So Unusual Sign in PRUNE1-Related Encephalopathy

Journal of Pediatric Neurology ◽

10.1055/s-0040-1715526 ◽

2020 ◽

Author(s):

Roberta Battini ◽

Enrico Bertini ◽

Roberta Milone ◽

Chiara Aiello ◽

Rosa Pasquariello ◽

...

Keyword(s):

Nervous System ◽

Differential Diagnosis ◽

Clinical Features ◽

Neurodevelopmental Disorder ◽

Recurrent Mutation ◽

Clinical Suspicion ◽

Alexander Disease ◽

Brain Anomalies ◽

Progressive Encephalopathy ◽

Core Features

Abstract PRUNE1-related disorders manifest as severe neurodevelopmental conditions associated with neurodegeneration, implying a differential diagnosis at birth with static encephalopathies, and later with those manifesting progressive brain damage with the involvement of both the central and the peripheral nervous system.Here we report on another patient with PRUNE1 (p.Asp106Asn) recurrent mutation, whose leukodystrophy, inferior olives hyperintensity, and macrocephaly led to the misleading clinical suspicion of Alexander disease. Clinical features, together with other recent descriptions, suggest avoiding the term “microcephaly” in defining this disorder that could be renamed “neurodevelopmental disorder with progressive encephalopathy, hypotonia, and variable brain anomalies” (NPEHBA).

Download Full-text

Stroke due to isolated angiitis ot the central nervous system (CNS) – differential diagnosis and therapy

Neuropediatrics ◽

10.1055/s-2004-819420 ◽

2004 ◽

Vol 35 (01) ◽

Author(s):

S Springer ◽

S Bechthold ◽

A Jansson ◽

K Kurnik ◽

T Pfluger ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Diagnosis And Therapy ◽

The Central Nervous System

Download Full-text

Primary Intracranial Malignant Melanoma Mimicking Meningioma—Report of Two Cases

Indian Journal of Neurosurgery ◽

10.1055/s-0040-1714167 ◽

2021 ◽

Author(s):

Laxmikant Bhople ◽

Hrushikesh U. Kharosekar ◽

Harish Naik ◽

V. Velho

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Malignant Melanoma ◽

Radiological Patterns

AbstractPrimary intracranial melanoma is uncommon and accounts for only approximately 1% of all cases of melanoma. This is interesting to neuro-oncologists and neurosurgeons because the clinical and radiological patterns of these tumors can mimic the presence of meningioma. Primary central nervous system melanomas have rarely been reported with less than 25 cases reported till date. We report two cases of the primary intracranial melanoma that even though very rare should be kept as a differential diagnosis when meningioma is suspected.

Download Full-text

Acute Disseminated Encephalomyelitis (ADEM): A Demyelinating Disease with Specific Morphological Features

International Journal of Surgical Pathology ◽

10.1177/1066896921993562 ◽

2021 ◽

pp. 106689692199356

Author(s):

Fleur Cordier ◽

Lars Velthof ◽

David Creytens ◽

Jo Van Dorpe

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Clinical Case ◽

Demyelinating Disease ◽

Acute Disseminated Encephalomyelitis ◽

Demyelinating Diseases ◽

Demyelinating Disorder ◽

Immune Mediated ◽

The Central Nervous System

Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory and demyelinating disorder of the central nervous system. Its characteristic perivenular demyelination and inflammation aid in the differential diagnosis with other inflammatory demyelinating diseases. Here, we present a clinical case of ADEM, summarize its histological hallmarks, and discuss pitfalls concerning the most important neuropathological differential diagnoses.

Download Full-text

Local Anesthetic-Induced Central Nervous System Toxicity during Interscalene Brachial Plexus Block: A Case Series Study of Three Patients

Journal of Clinical Medicine ◽

10.3390/jcm10051013 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1013

Author(s):

Daniel Spitzer ◽

Katharina J. Wenger ◽

Vanessa Neef ◽

Iris Divé ◽

Martin A. Schaller-Paule ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Brachial Plexus ◽

Local Anesthetic ◽

Local Anesthetics ◽

Brachial Plexus Block ◽

Central Nervous System Toxicity ◽

Interscalene Brachial Plexus Block ◽

Plexus Block ◽

System Toxicity

Local anesthetics are commonly administered by nuchal infiltration to provide a temporary interscalene brachial plexus block (ISB) in a surgical setting. Although less commonly reported, local anesthetics can induce central nervous system toxicity. In this case study, we present three patients with acute central nervous system toxicity induced by local anesthetics applied during ISB with emphasis on neurological symptoms, key neuroradiological findings and functional outcome. Medical history, clinical and imaging findings, and outcome of three patients with local anesthetic-induced toxic left hemisphere syndrome during left ISB were analyzed. All patients were admitted to our neurological intensive care unit between November 2016 and September 2019. All three patients presented in poor clinical condition with impaired consciousness and left hemisphere syndrome. Electroencephalography revealed slow wave activity in the affected hemisphere of all patients. Seizure activity with progression to status epilepticus was observed in one patient. In two out of three patients, cortical FLAIR hyperintensities and restricted diffusion in the territory of the left internal carotid artery were observed in magnetic resonance imaging. Assessment of neurological severity scores revealed spontaneous partial reversibility of neurological symptoms. Local anesthetic-induced CNS toxicity during ISB can lead to severe neurological impairment and anatomically variable cerebral lesions.

Download Full-text

Autoantibodies in Neuropsychiatric Systemic Lupus Erythematosus (NPSLE): Can They Be Used as Biomarkers for the Differential Diagnosis of This Disease?

Clinical Reviews in Allergy & Immunology ◽

10.1007/s12016-021-08865-2 ◽

2021 ◽

Author(s):

Elias Manca

Keyword(s):

Systemic Lupus Erythematosus ◽

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Human Body ◽

Lupus Erythematosus ◽

Neuropsychiatric Symptoms ◽

Systemic Lupus ◽

Neuropsychiatric Systemic Lupus Erythematosus ◽

The Central Nervous System

AbstractSystemic lupus erythematosus is a complex immunological disease where both environmental factors and genetic predisposition lead to the dysregulation of important immune mechanisms. Eventually, the combination of these factors leads to the production of self-reactive antibodies that can target any organ or tissue of the human body. Autoantibodies can form immune complexes responsible for both the organ damage and the most severe complications. Involvement of the central nervous system defines a subcategory of the disease, generally known with the denomination of neuropsychiatric systemic lupus erythematosus. Neuropsychiatric symptoms can range from relatively mild manifestations, such as headache, to more severe complications, such as psychosis. The evaluation of the presence of the autoantibodies in the serum of these patients is the most helpful diagnostic tool for the assessment of the disease. The scientific progresses achieved in the last decades helped researchers and physicians to discover some of autoepitopes targeted by the autoantibodies, although the majority of them have not been identified yet. Additionally, the central nervous system is full of epitopes that cannot be found elsewhere in the human body, for this reason, autoantibodies that selectively target these epitopes might be used for the differential diagnosis between patients with and without the neuropsychiatric symptoms. In this review, the most relevant data is reported with regard to mechanisms implicated in the production of autoantibodies and the most important autoantibodies found among patients with systemic lupus erythematosus with and without the neuropsychiatric manifestations.

Download Full-text

First Presentation of an Acquired Demyelinating Syndrome

Journal of Pediatric Neurology ◽

10.1055/s-0037-1606380 ◽

2017 ◽

Vol 16 (03) ◽

pp. 164-170

Author(s):

Rachel Gottlieb-Smith ◽

Amy Waldman

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Optic Neuritis ◽

Clinical Features ◽

Neuromyelitis Optica ◽

Transverse Myelitis ◽

Acute Disseminated Encephalomyelitis ◽

The Central Nervous System

AbstractAcquired demyelinating syndromes (ADS) present with acute or subacute monofocal or polyfocal neurologic deficits localizing to the central nervous system. The clinical features of distinct ADS have been carefully characterized including optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis. These disorders may all be monophasic disorders. Alternatively, optic neuritis, partial transverse myelitis, and acute disseminated encephalomyelitis may be first presentations of a relapsing or polyphasic neuroinflammatory disorder, such as multiple sclerosis or neuromyelitis optica. The clinical features of these disorders and the differential diagnosis are discussed in this article.

Download Full-text