scholarly journals Pseudo-insular glioma syndrome: illustrative cases

2021 ◽  
Vol 2 (26) ◽  

BACKGROUND Lower-grade insular gliomas often appear as expansile and infiltrative masses on magnetic resonance imaging (MRI). However, there are nonneoplastic lesions of the insula, such as demyelinating disease and vasculopathies, that can mimic insular gliomas. OBSERVATIONS The authors report two patients who presented with headaches and were found to have mass lesions concerning for lower-grade insular glioma based on MRI obtained at initial presentation. However, on the immediate preoperative MRI obtained a few weeks later, both patients had spontaneous and complete resolution of the insular lesions. LESSONS Tumor mimics should always be in the differential diagnosis of brain masses, including those involving the insula. The immediate preoperative MRI (within 24–48 hours of surgery) must be compared carefully with the initial presentation MRI to assess interval change that suggests tumor mimics to avoid unnecessary surgical intervention.

2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.


2021 ◽  
Vol 28 (5) ◽  
pp. 4016-4030
Author(s):  
Katarzyna Steinhof-Radwańska ◽  
Andrzej Lorek ◽  
Michał Holecki ◽  
Anna Barczyk-Gutkowska ◽  
Anna Grażyńska ◽  
...  

Background: The multifocality and multicentrality of breast cancer (MFMCC) are the significant aspects that determine a specialist’s choice between applying breast-conserving therapy (BCT) or performing a mastectomy. This study aimed to assess the usefulness of mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in women diagnosed with breast cancer before qualifying for surgical intervention to visualize other (additional) cancer foci. Methods: The study included 60 breast cancer cases out of 630 patients initially who underwent surgery due to breast cancer from January 2015 to April 2019. MG, CESM, and MRI were compared with each other in terms of the presence of MFMCC and assessed for compliance with the postoperative histopathological examination (HP). Results: Histopathological examination confirmed the presence of MFMCC in 33/60 (55%) patients. The sensitivity of MG in detecting MFMCC was 50%, and its specificity was 95.83%. For CESM, the sensitivity was 85.29%, and the specificity was 96.15%. For MRI, all the above-mentioned parameters were higher as follows: sensitivity—91.18%; specificity—92.31%. Conclusions: In patients with MFMCC, both CESM and MRI are highly sensitive in the detection of additional cancer foci. Both CESM and MRI change the extent of surgical intervention in every fourth patient.


2021 ◽  
pp. 442-444
Author(s):  
Aarti Mahesh Khare ◽  
Sachin Tukaram Nemane ◽  
Prashant Shridhar Javade ◽  
Yogesh Pralhad Narkhede ◽  
Punita A. Parti

Mucormycosis is an opportunistic fungal infection caused by omnipresent fungi called Mucorales of class Phycomycetes. It mainly occurs in immunocompromised patients, and only early diagnosis with medical and surgical intervention remains the gold standard in managing it. Here, we present the case of a patient contracted with mucormycosis post his COVID-19 infection involving the rhino-orbito-maxillary area. The patient presented to our hospital with dental pain a month after his discharge. Since the mucormycosis cases were at a peak in this period, our team of doctors did a thorough examination of the patient, which revealed dental and ophthalmologic abnormalities. No clinical necrotic eschar in the palatine or nasal cavity was diagnosed, but magnetic resonance imaging (MRI) revealed a typical COVID-19 mucormycosis infection. Accordingly, prompt treatment with systemic amphotericin B was started. However, as the patient declined surgical intervention, we feared the worst outcome, which to our surprise showed no adverse progression.


2021 ◽  
Vol 3 ◽  
pp. 14-23
Author(s):  
Vaishali Upadhyaya ◽  
Hema Nalini Choudur

Peripheral neuropathy (PN) can be due to either entrapment or other causes such as trauma, infection, inflammation, and mass lesions. Evaluation of peripheral nerves was previously limited to history, clinical examination, and electrodiagnostic tests. However, now, with advances in imaging, both ultrasound (US) and magnetic resonance imaging (MRI) enable excellent evaluation of the peripheral nerves. US can be used for preliminary imaging of patients with PN and MRI can be done if US results are inadequate or equivocal.


2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Carmine Franco Muccio ◽  
Luca De Lipsis ◽  
Rossella Belmonte ◽  
Alfonso Cerase

Marchiafava-Bignami Disease (MBD) is a toxic demyelinating disease often diagnosed in chronic alcoholics. The disease process typically involves the corpus callosum and clinically presents with various manifestations resulting in MBD type A and type B on the basis of clinical condition, extent of callosal involvement and extracallosal involvement at brain magnetic resonance imaging (MRI), and prognosis. The death rate is high. We report a patient affected by MBD type B, who presented an isolated reversible splenial lesion at brain MRI and achieved a favorable recovery.


1986 ◽  
Vol 27 (4) ◽  
pp. 369-377 ◽  
Author(s):  
D. J. Hamlin ◽  
H. Pettersson ◽  
J. O. Johnson ◽  
J. R. Fitzsimmons

The recent development of improved commercial radiofrequency coils and multiecho, multislice software for low field strength magnetic resonance systems has markedly increased the clinical utility of magnetic resonance imaging (MRI) of the pelvis at low field strengths. An evaluation of 70 patients with a variety of pelvic lesions and 14 normal volunteers who were studied using 0.15 T resistive magnet scanner revealed that anatomic structures and a variety of mass lesions could be clearly depicted in transaxial, sagittal and coronal planes using this updated system. Accurate characterization of lesions was possible in many instances using T2 weighted multiecho scans with echo time (TE) ranging from 30 ms to 120 ms (45 ms–180 ms using a reduced bandwidth technique). T1 weighted multislice scans demonstrated anatomic structures to best adantage and calculation of T1 and T2 relaxation times frequently facilitated more accurate differential diagnosis, particularly in the case of ovarian lesions.


2013 ◽  
Vol 19 (8) ◽  
pp. 1101-1105 ◽  
Author(s):  
Syrone Liu ◽  
Jonathan Kullnat ◽  
Dennis Bourdette ◽  
Jack Simon ◽  
Dale F Kraemer ◽  
...  

Background: Incidental T2 white matter hyperintensities (WMHs) in headache patients on brain magnetic resonance imaging (MRI) may prompt concern for demyelinating disease. Objective: We reviewed brain MRI studies in patients with headaches without known demyelinating disease to determine the prevalence meeting imaging criteria for multiple sclerosis (MS) using two different definitions of “juxtacortical” and “periventricular”. Methods: Consecutive patients undergoing pre- and post-contrast MRI for headaches over a 25-month period were retrospectively identified. Exclusions included patients under age 10 and over 55 years or with known demyelinating disorder. Patients were classified as meeting: 1) Barkhof and 2) 2010 McDonald dissemination in space criteria for MS based on: FLAIR/T2 scans for WMH and enhanced T1-weighted images for enhancement. Both groups were further differentiated by defining “periventricular” and “juxtacortical” as WMH contacting ventricle and cortex (Barkhof “touching”, McDonald “touching”) versus WMH within 3 mm (Barkhof – 3 mm, McDonald – 3 mm). Results: 326/564 (58%) studies met inclusion criteria. WMH prevalence was 168/326 (51.53%). Barkhof “touching” criteria were met in 4/168 (2.4%) and in 12/168 (7.1%) of the 3 mm group. McDonald criteria were met in 41/168 (24.4%) for “touching” and 58/168 (34.5%) for 3 mm, respectively. Conclusion: Barkhof and McDonald criteria were met in 2.4–7.1% and 24.4–34.5%, respectively.


2021 ◽  
Vol 8 (04) ◽  
pp. 5338-5340
Author(s):  
Yuri Haiga

 Background: Spondylitis TB is an infection of Mycobacterium TB involving the spine. The course of spondylitis TB is relatively indolent. This study was conducted to evaluate the clinical presentation and a goal of surgery in two patients who had been operated for spondylitis tuberculosis (TB) in Siti Rahmah Hospital during Covid-19 pandemic. Case Report: Case 1, A 24-year-old woman, presented to the emergency department with a complaint of nausea, vomiting, weight loss, and severe back pain. On admission she was febrile and had leukocytosis. Initial spinal x-ray was performed and revealed osteolytic changes in the vertebral body of T10 and T11. Magnetic resonance imaging (MRI) of the spine illustrated spondylitis of T8 until T12, with paravertebral abscesses, which was suggestive spondylitis. Case 2, A 19-year-old woman, presented to policlinic with complain of paraplegi inferior and hipoestesi since 7 month ago. Magnetic resonance imaging (MRI) of the spine illustrated spondylitis of C7 until T4, with paravertebral abscesses, which was suggestive spondylitis. Both patients were operated on by an orthopedic doctor. Anatomical Pathology examination showed tuberculosis spodylitis. The patient treat surgical intervention and anti-tuberculosis drug. After surgical intervention, patient had improvement of sensoric and motoric. Conclusions: In a covid-19 pandemic situation, diagnosis and management of spondylitis TB must be carried out because it is related to the prognosis of the disease.   Keywords: Mycobacterium tuberculosis; Spondylitis, Covid-19 Pandemic


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