scholarly journals Presentation, diagnosis, and treatment of a cerebellar tuberculoma: illustrative case

2021 ◽  
Vol 2 (18) ◽  
Author(s):  
Stephen Capone ◽  
Dokpe Emechebe ◽  
Eric G. St. Clair ◽  
Ali Sadr ◽  
Michelle Feinberg
Keyword(s):  
Diagnosis And Treatment ◽  
Cerebellar Hemisphere ◽  
Illustrative Case ◽  
Suboccipital Craniotomy ◽  
Normal Limits ◽  
Caseating Granuloma ◽  
Night Sweats ◽  
History Of ◽  
Latent Tb Infection ◽  
The Right

BACKGROUND Central nervous system (CNS) tuberculomas are a feared complication of tuberculosis (TB) infection. These lesions can present in varying manners and are associated with significant morbidity and mortality. Prompt diagnosis and treatment of the lesion and the underlying infection are critical in the care of these patients. The authors presented a case of a 45-year-old Yemeni immigrant presenting with a 3-month history of severe right temporo-occipital headaches with photophobia and night sweats. Imaging showed a rim-enhancing lesion in the right cerebellar hemisphere. OBSERVATIONS Laboratory tests were unremarkable and within normal limits. QuantiFERON testing was negative, ruling out latent TB infection. The patient received a suboccipital craniotomy, and resection of the cerebellar lesion showed caseating granuloma formation, which was positive for acid-fast bacilli and Fite stain. LESSONS CNS tuberculomas are an important differential to consider in patients with a history of primary TB, regardless of active disease or immunocompetent status. Resection of these lesions remains a viable treatment option that is safe and effective.

scholarly journals P.158 Feeling Green

2021 ◽  
Vol 48 (s3) ◽  
pp. S65-S65
Author(s):  
A Ghare ◽  
K Langdon ◽  
A Andrade ◽  
R Kiwan ◽  
A Ranger ◽  
...  
Keyword(s):  
Brain Parenchyma ◽  
Myeloid Sarcoma ◽  
Cerebellar Hemisphere ◽  
Hematologic Neoplasms ◽  
Short History ◽  
History Of ◽  
Immature Myeloid Cells ◽  
Long Course ◽  
The Right ◽  
The Brain

Background: Myeloid sarcoma (MS) is a rare solid tumour made of myeloblasts or immature myeloid cells in an extramedullary site or in bone, associated with systemic hematologic neoplasms. When they occur in the brain parenchyma, they can often be misdiagnosed. Methods: The authors report a case of a 4-year old boy 6 months out of remission from AML, presenting with a short history of headaches and vomiting, and found to have a heterogenous contrast-enhancing lesion in the right cerebellar hemisphere, with differential diagnosis of myeloid sarcoma, astrocytoma, medulloblastoma and ATRT. Preliminary diagnosis was made flow cytometry from an intraoperative biopsy. The patient had a long course of chemotherapy and radiation, but eventually died from the systemic burden of his AML. Results: The authors present a literature review on 178 published cases of CNS myeloid sarcomas, and their radiological presentation and the basis of immunohistochemical and pathological diagnosis is discussed. Conclusions: Diagnosis rests on a combination of immunohistochemistry and histopathology of biopsied tissue. Surgical resection is controversial, especially given the efficacy of chemotherapy and radiation, and prognosis remains unclear. As with all uncommon and rare clinical entities, further investigation is warranted to determine prognosis and optimal management of CNS myeloid sarcomas.

scholarly journals A case of periosteal proliferative polyarthritis in a cat

2017 ◽  
Vol 55 (1) ◽  
pp. 46
Author(s):  
M. KARAYANNOPOULOU (Μ. ΚΑΡΑΓΙΑΝΝΟΠΟΥΛΟΥ) ◽  
Z. S. POLIZOPOULOU (Ζ.Σ. .ΠΟΛΥΖΟΠΟΥΛΟΥ) ◽  
A. F. KOUTINAS (Α. Φ. ΚΟΥΤΙΝΑΣ) ◽  
M. N. PATSIKAS (Μ.Ν. ΠΑΤΣΙΚΑΣ) ◽  
G. KAZAKOS (Γ. ΚΑΖΑΚΟΣ) ◽  
...  
Keyword(s):  
Elbow Joint ◽  
Complete Blood Count ◽  
Weight Bearing ◽  
Serum Biochemistry ◽  
Adverse Side Effect ◽  
Left Elbow ◽  
Normal Limits ◽  
Thoracic Limb ◽  
History Of ◽  
The Right

In this paper a case of periosteal proliferative polyarthritis in an 11-year old, female Siamese cat, that was admitted to the Surgery Clinic of the Veterinary School, A.U.Th., with a 6-month history of non-weight bearing lameness of the left thoracic limb, is described. At physical examination, restricted range of motion of the left elbow joint, local swelling and pain were detected. In the radiological examination of the affected joint the main finding was a periarticular extensive and irregular periosteal new bone formation. The results of the complete blood count and routine serum biochemistry were within normal limits and the cat was serologically negative for FeLV and FIV. Synovial fluid examination showed a lymphoplasmacytic pleocytosis, while the bacterial culture was negative. Prednisolone given at an anti-inflammatory dose for two consecutive weeks resulted in a marked improvement of the clinical sings. However, two months after the end of the treatment lameness reappeared, but this time in the contralateral thoracic limb, due to the involvement of the same joint. Radiology revealed the same type of lesions in the right elbow joint, whereas the left became ankylosed. Again, prednisolone, given at an immunosuppressive dose for two weeks, did not improve but fairly the clinical condition of the animal and the radiological changes as well. For this reason azathioprine at the dose of 1 mg/kg BW, every 48 hours, was added to therapy that lasted for 5 months. Transient mild leukopenia, that resolved after decreasing the dose of azathioprine by 25%, was the only adverse side effect noticed. At the end of the treatment, regression of the radiographical lesions in both elbows enabled the cat to walk with a stilted gait, despite the development of joint ankylosis bilaterally. The disease was kept in remission during the 12-month follow up period.

Differential Diagnosis and Treatment in a Patient With Posterior Upper Thoracic Pain

2006 ◽  
Vol 86 (2) ◽  
pp. 254-268 ◽  
Author(s):  
Stacie J Fruth
Keyword(s):  
Differential Diagnosis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Trigger Points ◽  
Diagnosis And Treatment ◽  
Thoracic Pain ◽  
Patient Reported ◽  
History Of ◽  
The Right ◽  
Upper Thoracic

Background and Purpose. Determining the source of a patient's pain in the upper thoracic region can be difficult. Costovertebral (CV) and costotransverse (CT) joint hypomobility and active trigger points (TrPs) are possible sources of upper thoracic pain. This case report describes the clinical decision-making process for a patient with posterior upper thoracic pain. Case Description. The patient had a 4-month history of pain; limited cervical, trunk, and shoulder active range of motion; limited and painful mobility of the right CV /CT joints of ribs 3 through 6; and periscapular TrPs. Interventions included CV / CT joint mobilizations, TrP release, and flexibility and postural exercises. Outcomes. The patient reported intermittent mild discomfort after 7 physical therapy sessions. Examination findings were normal, and he was able to resume all preinjury activities. Discussion. This case suggests that CV /CT mobilizations and active TrP release may have been beneficial in reducing pain and restoring function in this patient. [Fruth SJ. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Phys Ther. 2006;86:254-268.]

scholarly journals Spontaneous Cervical Epidural Hematoma with Hemiparesis Mimicking Cerebral Stroke

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mehmet Tiryaki ◽  
Recep Basaran ◽  
Serdar Onur Aydin ◽  
Mustafa Efendioglu ◽  
Ece Balkuv ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Epidural Hematoma ◽  
Rare Condition ◽  
Diagnosis And Treatment ◽  
Cerebral Stroke ◽  
Normal Limits ◽  
Cranial Mri ◽  
Spinal Mri ◽  
The Right ◽  
Loss Of Strength

Aim.Spontaneous cervical epidural hematoma (SCEH) is defined as an epidural hematoma that does not have an etiological explanation. The most common site for SCEH is cervicothoracic area. Early diagnosis and treatment are important for prognosis and good results. In this paper, we aimed to present a case who complains of sudden weakness on right extremities imitating cerebral stroke and that neuroimaging reveals spontaneous cervical epidural hematoma.Case.A 72-year-old woman was admitted to our hospital with acute neck pain and loss of strength on right extremities. On neurological examination, the patient had right hemiparesis. PT, aPTT, and INR results were 50.5, 42.8, and 4.8, respectively. Cranial MRI was in normal limits. Spinal MRI revealed a lesion that extends from C4 to C7 located on the right side and compatible with epidural hematoma. The patient was operated after normalization of INR values.Conclusion.Even though SCEH is a rare condition, it can cause severe morbidity and mortality. Early diagnosis and treatment are quiet important for prognosis. SCEH can easily be mistaken for stroke as with other pathologies and this diagnosis should come to mind especially in patients who have diathesis of bleeding.

scholarly journals Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Fiorella Villano ◽  
Adriana Peixoto ◽  
Eloísa Riva ◽  
Carina Di Matteo ◽  
Lilián Díaz
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Connective Tissue Diseases ◽  
Hodgkin's Lymphoma ◽  
Male Smoker ◽  
Digital Ischemia ◽  
Night Sweats ◽  
History Of ◽  
Painless Mass ◽  
The Right ◽  
Vascular Syndromes

Digital ischemia is associated with atherosclerotic, thromboembolic, or connective tissue diseases. Less often, it can be related to malignancy. Paraneoplastic vascular acrosyndromes (Raynaud’s syndrome, acrocianosis, and acronecrosis) are associated with adenocarcinoma and less frequently with hematological malignancies. We report the case of a 45-year-old male, smoker, with a 10-day history of pain, cyanosis, and progressive digital necrosis in both hands. In the previous four months, he noticed painless mass in the right axillary gap, drenching night sweats, and weight loss. Physical examination at admission highlighted necrotic lesions on the distal phalanges of both hands (except the thumbs), enlarged lymph nodes in right axillary, and right supraclavicular gaps. Arteriography of upper limbs demonstrated a distal stop in all bilateral digital arteries. Digital ischemia was interpreted as a paraneoplastic phenomenon after other common etiologies were ruled out. Amputation of three phalanges was required due to necrosis. Biopsy of axillary nodes demonstrated nodular sclerosis classical Hodgkin’s lymphoma (HL). The patient started conventional ABVD protocol (doxorubicin, bleomycin, vinblastine, and dacarbazine). After 6 cycles, he remained asymptomatic and symptoms of digital ischemia were completely resolved. It was concluded that the presence of acral vascular syndromes should alert the physician about the possibility of underlying malignant disease. Prompt investigation and treatment should be rapidly performed to avoid digital sequelae.

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

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.

scholarly journals SURGICAL APPROACH OF HYPERTENSION: PHEOCHROMOCYTOMA CASE REPORT

2015 ◽  
Vol 2 (1) ◽  
pp. 15-19
Author(s):  
Adriana Ion ◽  
I. Bostaca
Keyword(s):  
Blood Pressure ◽  
Adrenal Gland ◽  
Ventricular Arrhythmias ◽  
Low Salt ◽  
Rapid Pulse ◽  
Night Sweats ◽  
History Of ◽  
The Right ◽  
Solid Type

Pheochromocytoma is present in about 1% of hypertensive patients. It has a 90% cure potential, but a high mortality rate if left untreated. Complications include malignant hypertension, heart failure, myocardial infarction, ventricular arrhythmias, stroke or metastasis (malignant pheochromocytoma). We present the case of a 47-year-old hypertensive female patient who was admitted to hospital in 2014 with excessive fluctuations in blood pressure (300/140 mmHg to 90/50 mmHg), rapid pulse not responding to medication, profuse night sweats, palpitations, vertigo, nausea, and vomiting. The patient had a history of high arterial pressure dating back to 1996, following complex anti-hypertensive treatment, and frequent episodes of paroxysmal atrial fibrillation in the previous four years, reduced by external electric shock. Laboratory and imaging investigations revealed a solid-type formation with mixed structure in the right adrenal gland, indicating pheochromocytoma. Surgery with resection of the right adrenal gland was proposed. Preoperative preparation to combat the risks of large variations in blood pressure and hypovolemia started 1–3 weeks before surgery, consisting of an alpha-blocker to control blood pressure, a beta-blocker to prevent arrhythmic events, and hydration to prevent postoperative hypotension. A right adrenalectomy was performed. Histopathology of the resected piece confirmed the diagnosis of pheochromocytoma. After surgery, the large variations in blood pressure, arrythmic events and tumor symptoms were all reduced, and blood pressure returned to within normal range. Follow-up treatment consisted of Carvedilol 12.5 mg, 1 cp / day and a low-salt, hypolipidaemic diet was recommended. The case is notable for the late diagnosis made about 18 years after the onset of the hypertensive symptoms, treated with excessive medication.

scholarly journals AN UNUSUAL CASE OF CEREBELLAR VENOUS ANGIOMA ASSOCIATED WITH TEMPORAL CAVERNOMA – PATHOPHYSIOLOGICAL, DIAGNOSTIC, AND SURGICAL CONSIDERATIONS

2015 ◽  
Vol 2 (4) ◽  
pp. 198-203
Author(s):  
Tabita Larisa Caza ◽  
Ioana Andreea Dărămuș ◽  
B. C. Dumitrescu ◽  
V. Ciubotaru ◽  
Ligia Gabriela Tătăranu
Keyword(s):  
Vascular Malformations ◽  
Cerebellar Hemisphere ◽  
Central Vein ◽  
Venous Angioma ◽  
Total Recovery ◽  
Cavernous Malformations ◽  
Normal Limits ◽  
Grand Mal ◽  
Microsurgical Resection ◽  
The Right

Cerebral vascular malformations are hamartomas, classified into four distinct groups:arteriovenous malformations, cavernous malformations, capillary telangiectasias, anddevelopmental venous anomalies. These abnormal vascular entities have distinct histopathological, radiological, and clinical features, which make them different from one another. We report a case of a 37-year-old man, who presented with headaches, generalized grand mal seizures, and an episode of loss of consciousness, due to a left temporal cavernoma. Gadolinium-enhanced T1-weighted MR images showed a left temporal “popcorn-like” lesion, with heterogeneousenhancement, measuring 15/17/18 mm, suggestive of a cavernoma (angiographically occultmalformation). The T2-weighted MRI showed a right cerebellar venous plexus, draining into alarger central vein and the angiogram revealed the pathognomonic caput medusae aspect of avenous angioma. Microsurgical resection of the left temporal cavernous malformation wasperformed using a left frontal temporal approach. The venous angioma was spared to avoid venousinfarction and cerebral edema with devastating vital consequences. The intra- and postoperativecourses were uneventful with total recovery. The seizures remitted under anticonvulsant therapy,and the postoperative computer tomography investigation were within normal limits. The venous angioma was situated in the right cerebellar hemisphere, rather than near the cavernoma, its location making this the particular aspect of this case.

The Sensed Presence as Right Hemispheric Intrusions into the Left Hemispheric Awareness of Self: An Illustrative Case Study

1994 ◽  
Vol 78 (3) ◽  
pp. 999-1009 ◽  
Author(s):  
Michael A. Persinger ◽  
Yves R. J. Bureau ◽  
Oksana P. Peredery ◽  
Pauline M. Richards
Keyword(s):  
Medical History ◽  
Temporal Lobe ◽  
Sense Of Self ◽  
Illustrative Case ◽  
History Of ◽  
Illustrative Case Study ◽  
The Right

The hypothesis of vectorial hemisphericity predicts that left hemispheric intrusions of the right hemispheric equivalent of the sense of self should be associated with the experience of a “presence” of someone else. The neurophenomenological profile of a woman whose medical history satisfied these theoretical criteria (verified electrical anomalies that could encourage phasic discharges within the right temporal lobe and atrophy within the left temporoparietal region) is presented. In addition to interactions between electrical seizures and thinking, she reported a long history of sensed presences, ego-alien intrusions, and “sudden knowing of the subsequent sequences of seizures” before they occurred clinically. The existence of these neurocognitive processes demands a reevaluation of the psychiatric default explanations of “hysteria” and questions the belief that “awareness during seizures” or “premonition of subsequent somatosensory experience” contraindicates an epileptic process.

scholarly journals FatalBalamuthia mandrillarisEncephalitis

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Binoy Yohannan ◽  
Mark Feldman
Keyword(s):  
Cerebellar Hemisphere ◽  
Balamuthia Mandrillaris ◽  
Granulomatous Amoebic Encephalitis ◽  
History Of ◽  
Left Cerebellar Hemisphere ◽  
The Right ◽  
Immunohistochemical Studies ◽  
The Brain ◽  
Caucasian Female ◽  
Hiv Negative

Balamuthia mandrillarisis a rare cause of granulomatous meningoencephalitis associated with high mortality. We report a 69-year-old Caucasian female who presented with a 3-day history of worsening confusion and difficulty with speech. On admission, she was disoriented and had expressive dysphasia. Motor examination revealed a right arm pronator drift. Cerebellar examination showed slowing of finger-nose testing on the left. She was HIV-negative, but the absolute CD4 count was low. Neuroimaging showed three cavitary, peripherally enhancing brain lesions, involving the right frontal lobe, the left basal ganglia, and the left cerebellar hemisphere. She underwent right frontal craniotomy with removal of tan, creamy, partially liquefied necrotic material from the brain, consistent with granulomatous amoebic encephalitis on tissue staining. Immunohistochemical studies and PCR tests confirmed infection withBalamuthia mandrillaris. She was started on pentamidine, sulfadiazine, azithromycin, fluconazole, flucytosine, and miltefosine. The postoperative course was complicated by an ischemic stroke, and she died a few weeks later.

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