Infectious meningitis mimicking recurrent medulloblastoma on magnetic resonance imaging

1999 ◽  
Vol 91 (3) ◽  
pp. 499-502 ◽  
Author(s):  
Maryam Fouladi ◽  
Richard Heideman ◽  
James W. Langston ◽  
Larry E. Kun ◽  
Stephen J. Thompson ◽  
...  

✓ This report and the accompanying review of the literature address the challenges, when using surveillance magnetic resonance (MR) imaging, of establishing the origin of newly detected central nervous system lesions. Routine surveillance MR imaging in a 16-year-old boy, whose medulloblastoma had been successfully treated, demonstrated asymptomatic nodular leptomeningeal enhancement of the brain and spinal cord, which was consistent with recurrent disease. Examination of the cerebrospinal fluid, however, led to the diagnosis of bacterial meningitis. Two weeks after completion of antibiotic therapy, the original MR imaging findings were seen to have resolved. This case illustrates the importance of considering clinical and laboratory data, including results from a complete examination of the cerebrospinal fluid, when interpreting the origin of new lesions revealed by MR imaging.

2003 ◽  
Vol 99 (3) ◽  
pp. 313-315 ◽  
Author(s):  
Shinobu Takahashi ◽  
Shigehiro Morikawa ◽  
Masaaki Egawa ◽  
Yasuo Saruhashi ◽  
Yoshitaka Matsusue

✓ The authors describe the case of a high cervical, intradural extramedullary cyst located anterior to the spinal cord in a 13-year-old boy. The lesion was fenestrated percutaneously by using real-time magnetic resonance (MR) imaging guidance and a local anesthetic agent. The patient's symptom, severe exercise-induced headache, immediately resolved after treatment. Nine months later, complete disappearance of the cyst was confirmed on MR imaging and computerized tomography myelography. Magnetic resonance imageing—guided fenestration can be considered a minimally invasive option for intradural cystic lesions.


1988 ◽  
Vol 68 (2) ◽  
pp. 246-250 ◽  
Author(s):  
Gene H. Barnett ◽  
Allan H. Ropper ◽  
Keith A. Johnson

✓ Magnetic resonance (MR) imaging has been largely restricted to patients who are neurologically and hemodynamically stable. The strong magnetic field and radiofrequency transmissions involved in acquiring images are potential sources of interference with monitoring equipment. A method of support and physiological monitoring of critically ill neurosurgical and neurological patients during MR imaging using a 0.6-tesla MR system is reported. This technique has not caused degradation of the MR image due to electrical interference. Adequate preparation and precautions allow many critically ill neurosurgical and neurological patients to safely undergo MR imaging.


1999 ◽  
Vol 91 (3) ◽  
pp. 384-390 ◽  
Author(s):  
Faruk İldan ◽  
Metin Tuna ◽  
Alp İskender Göcer ◽  
Bülent Boyar ◽  
Hüseyin Bağdatoğlu ◽  
...  

Object. The authors examined the relationships of brain—tumor interfaces, specific magnetic resonance (MR) imaging features, and angiographic findings in meningiomas to predict tumor cleavage and difficulty of resection.Methods. Magnetic resonance imaging studies, angiographic data, operative reports, clinical data, and histopathological findings were examined retrospectively in this series, which included 126 patients with intracranial meningiomas who underwent operations in which microsurgical techniques were used. The authors have identified three kinds of brain—tumor interfaces characterized by various difficulties in microsurgical dissection: smooth type, intermediate type, and invasive type. The signal intensity on T1-weighted MR images was very similar regardless of the type of brain—tumor interface (p > 0.1). However, on T2-weighted images the different interfaces seemed to correlate very precisely with the signal intensity and the amount of peritumoral edema (p < 0.01), allowing the prediction of microsurgical effort required during surgery. On angiographic studies, the pial—cortical arterial supply was seen to participate almost equally with the meningeal—dural arterial supply in vascularizing the tumor in 57.9% of patients. Meningiomas demonstrating hypervascularization on angiography, particularly those fed by the pial—cortical arteries, exhibited significantly more severe edema compared with those supplied only from meningeal arteries (p < 0.01). Indeed, a positive correlation was found between the vascular supply from pial—cortical arteries and the type of cleavage (p < 0.05).Conclusions. In this analysis the authors proved that there is a strong correlation between the amount of peritumoral edema, hyperintensity of the tumor on T2-weighted images, cortical penetration, vascular supply from pial—cortical arteries, and cleavage of the meningioma. Therefore, the consequent difficulty of microsurgical dissection can be predicted preoperatively by analyzing MR imaging and angiographic studies.


2000 ◽  
Vol 93 (2) ◽  
pp. 237-244 ◽  
Author(s):  
Henry W. S. Schroeder ◽  
Christiane Schweim ◽  
Klaus H. Schweim ◽  
Michael R. Gaab

Object. The purpose of this prospective study was to evaluate aqueductal cerebrospinal fluid (CSF) flow after endoscopic aqueductoplasty. In all patients, preoperative magnetic resonance (MR) imaging revealed hydrocephalus caused by aqueductal stenosis and lack of aqueductal CSF flow.Methods. In 14 healthy volunteers and in eight patients with aqueductal stenosis who had undergone endoscopic aqueductoplasty, aqueductal CSF flow was investigated using cine cardiac-gated phase-contrast MR imaging. For qualitative evaluation of CSF flow, the authors used an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Quantitative through-plane measurements were performed in the axial plane perpendicular to the aqueduct. Evaluation revealed no significant difference in aqueductal CSF flow between healthy volunteers and patients with regard to temporal parameters, CSF peak and mean velocities, mean flow, and stroke volume. All restored aqueducts have remained patent 7 to 31 months after surgery.Conclusions. Aqueductal CSF flow after endoscopic aqueductoplasty is similar to aqueductal CSF flow in healthy volunteers. The data indicate that endoscopic aqueductoplasty seems to restore physiological aqueductal CSF flow.


2014 ◽  
Vol 3 (10) ◽  
pp. 204798161455221
Author(s):  
Melda Bozluolcay ◽  
Ayse D Elmali ◽  
Sukriye F Menku ◽  
Burcu Zeydan ◽  
Gulcin Benbir ◽  
...  

Background Creutzfeld-Jacob disease (CJD) is a rare, progressive disease that has a vast clinical manifestation range. Cranial magnetic resonance imaging (MRI), electroencephalography (EEG), and measurement of 14-3-3 in cerebrospinal fluid (CSF) may offer a pragmatic approach in the diagnosis of CJD as an alternative to histopathological confirmation. Purpose To present the symptoms and signs of the CJD patients in regard to radiological and neurophysiological findings. Material and Methods We collected all cases with the diagnosis of probable CJD admitted to our neurology department between June 2010 and June 2014. The medical records and laboratory data, clinical features, results of MRI (including diffusion weighted images), EEG and CSF evaluations, and other laboratory data to exclude other possible diagnoses were recorded. None of the patients underwent biopsy or autopsy for histological diagnosis. Results Of 20 patients, 11 (55%) were men and nine (45%) were women. The mean age at disease onset was 60.0 ± 9.5 years (age range, 47–80 years). All patients without exception had characteristic abnormalities in DWI and/or FLAIR on admission, about 4 months after the initial symptom. Periodic complexes on EEGs characteristic for CJD were detected only in 10 patients (50%) on admission and in 13 patients (65%) during disease course. Out of 14 patients who underwent CSF examination, 11 (78.5%) were positive for 14-3-3 protein. Conclusion Although the definite diagnosis of CJD is made histopathologically, we aimed to discuss the value of magnetic resonance imaging in the diagnosis of CJD in respect to EEG findings and protein 14-3-3 levels in CSF.


1989 ◽  
Vol 70 (3) ◽  
pp. 426-431 ◽  
Author(s):  
Bertil Romner ◽  
Magnus Olsson ◽  
Bengt Ljunggren ◽  
Stig Holtås ◽  
Hans Säveland ◽  
...  

✓ The magnetic properties of 12 different types of aneurysm clip were investigated in order to identify which clips allow postoperative magnetic resonance (MR) imaging without risk. Clip-induced MR artifacts were also quantitatively studied using a geometrical phantom. Nonferromagnetic aneurysm clips like the Yaşargil Phynox, Sugita Elgiloy, and Vari-Angle McFadden clips do not appear to contraindicate MR studies performed with a FONAR β-3000M imager. There is no clip movement upon introduction of the phantom into the MR imager, and the image artifacts caused by the clips are so limited that patients harboring such clips may well be considered for MR imaging. This examination may reveal information not obtainable by any other radiological modality.


1998 ◽  
Vol 88 (2) ◽  
pp. 247-254 ◽  
Author(s):  
Izumi Koyanagi ◽  
Yoshinobu Iwasaki ◽  
Kazutoshi Hida ◽  
Hiroyuki Imamura ◽  
Hiroshi Abe

Object. Because of the lack of magnetic resonance (MR) signal from cortical bones, MR imaging is inadequate for diagnosing ossified lesions in the spinal canal. However, MR imaging provides important information on spinal cord morphology and associated soft-tissue abnormality. The purpose of this study is to determine the role of MR imaging in the diagnosis and treatment of patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Methods. The authors reviewed MR imaging findings in 42 patients with cervical OPLL who were examined with a superconducting MR imaging system. The types of OPLL reviewed included eight cases of continuous, 21 cases of segmental, and 13 cases of the mixed type. All patients were treated surgically either by anterior (26 cases) or posterior decompression (16 cases). Conclusions. The T1-weighted images clearly demonstrated the spinal cord deformity caused by OPLL. Associated disc protrusion was found to be present at the maximum compression level in 60% of the patients in this series. The highest incidence of disc protrusion (81%) was found in patients with segmental OPLL. Intramedullary hyperintensity on T2*-weighted imaging was noted in 18 patients (43%). The neurological deficits observed in these 18 patients were significantly more severe than those observed in the other 24 patients. Postoperative MR imaging revealed improvement in the spinal cord deformity, although the intramedullary hyperintensity was still observed in most cases. The present study demonstrates the importance of associated disc protrusion in the development of myelopathy in patients with cervical OPLL. Magnetic resonance imaging findings may be used to help determine the actual levels of spinal cord compression and to suggest the method of surgical treatment.


2003 ◽  
Vol 99 (4) ◽  
pp. 772-774 ◽  
Author(s):  
Jörg Spiegel ◽  
Gerhard Fuss ◽  
Martin Backens ◽  
Wolfgang Reith ◽  
Tim Magnus ◽  
...  

✓ Data from previous studies have shown that magnetic resonance (MR) imaging of the head can be performed safely in patients with deep brain stimulators. The authors report on a 73-year-old patient with bilaterally implanted deep brain electrodes for the treatment of Parkinson disease, who exhibited dystonic and partially ballistic movements of the left leg immediately after an MR imaging session. Such dystonic or ballistic movements had not been previously observed in this patient. In the following months, this focal movement disorder resolved completely. This case demonstrates the possible risks of MR imaging in patients with deep brain stimulators.


1994 ◽  
Vol 80 (2) ◽  
pp. 321-323 ◽  
Author(s):  
Hirofumi Hirano ◽  
Kazuho Hirahara ◽  
Tetsuhiko Asakura ◽  
Tetsuro Shimozuru ◽  
Koki Kadota ◽  
...  

✓ A case is reported of hydrocephalus due to overproduction of cerebrospinal fluid (CSF) caused by villous hypertrophy of the choroid plexus in the lateral ventricles. A 7-year-old girl with mental retardation developed gait disturbance; hydrocephalus and a Dandy-Walker cyst were detected on computerized tomography. She was initially treated with a ventriculoperitoneal shunt; however, shunting failed to control the hydrocephalus. The excessive outflow of CSF suggested choroid plexus abnormality, and magnetic resonance (MR) imaging revealed enlargement of the choroid plexus in both lateral ventricles. The patient was therefore diagnosed as having hydrocephalus induced by overproduction of CSF, which was controlled by resection of the choroid plexus. Histological examination showed the structure typical of normal choroid plexus. This is a rare case of villous hypertrophy of the choroid plexus in which MR imaging assisted in the diagnosis.


2002 ◽  
Vol 97 ◽  
pp. 464-470 ◽  
Author(s):  
E. J. St. George ◽  
P. Butler ◽  
P. N. Plowman

Object. Current radiosurgical treatment of arteriovenous malformations (AVMs) relies on planning protocols that integrate data from both magnetic resonance (MR) imaging and stereotactic angiography studies. Angiography, however, is invasive and associated with a small but well-defined risk of neurological and systemic complications. Magnetic resonance imaging, on the other hand, is noninvasive with multiplanar capability, demonstrates good anatomical detail, and has been shown to be superior to angiography in the delineation of selected AVMs. Methods. In this study, MR imaging—related accuracy of defining the AVM nidus in gamma knife radiosurgery is investigated using only T1- and T2-weighted sequences. Conclusions. Little interobserver variability was observed and AVM nidi, as demonstrated on T1- and T2-weighted MR images, were well correlated in terms of size. The displacement of the new target, however, from the original nidus, was not predictable and occasionally was significant, thus precluding safe radiosurgical planning.


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