RARE PRESENTATION OF LHERMITTE-DUCLOS DISEASE

2021 ◽  
pp. 28-29
Author(s):  
Aarthi Parthasarathy ◽  
Muhil Kannan
Keyword(s):  
Benign Lesion ◽  
Mass Effect ◽  
Cerebellar Hemisphere ◽  
Glial Tumor ◽  
Rare Presentation ◽  
Hyperintense Lesion ◽  
Diffusion Weighted Images ◽  
History Of ◽  
Left Cerebellar Hemisphere ◽  
Contrast Ct

Lhermitte-Duclos disease (LDD) arises from an uncommon benign lesion which alters the normal cerebellar laminar pattern. This case report shows the imaging ndings of this condition in 39 year-old male, presented with history of headache and dizziness for duration of ten days. Intial assessment included a non-contrast CT which showed a mass in left cerebellar hemisphere with surrounding mass effect. MRI multiplanar sequences showed a well dened T2 hyperintense lesion with a tigroid appearance.The lesion showed a mild bright signal on diffusion-weighted images, whereas MR Spectroscopy shows reduced choline levels. Differential diagnosis in terms of imaging include subacute infarct, cerebellitis, glial tumor,encephalitis but these do not give the classical tigroid appearance on MRI. Lack of contrast enhancement , signicant diffusion and cellularity of the lesions can help in differentiating among them.

scholarly journals Warning with chronic subdural hematomas in the elderly

2021 ◽  
Vol 11 (4) ◽  
pp. 114-117
Author(s):  
Dinh Thi Phuong Hoai ◽  
Nguyen Thi My Dung ◽  
Hoang Manh Cuong ◽  
Huynh Thi Kieu Oanh ◽  
Ngo Thuy Tram ◽  
...  
Keyword(s):  
Left Hemisphere ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Mass Effect ◽  
The Elderly ◽  
Brain Parenchyma ◽  
History Of ◽  
Apparent Reason ◽  
The Right ◽  
Contrast Ct

Chronic subdural hematoma (cSDH) is a disorder in which blood collects between the dura and arachnoid mater of meninges around the brain. It's more common among the elderly and usually triggered by a head injury. We report a case of a 78-year-old male patient who had previously been diagnosed with a left hemisphere subdural hematoma for no apparent reason with a history of hypertension. Two days before hospitalizing, he had a symptom of weakness in the right extremities. Non-contrast CT of head reveals a crescent-shaped, heterodense lesion over the lateral aspect of the left hemisphere measuring 11x5x1 cm with mass effect to the adjacent brain parenchyma. Burr hole drainage was performed for the patient. His symptoms improved after the surgery.

Un caso di Neurofibromatosi di tipo 1 “complicata” da processo espansivo cerebellare maligno con aspetti TC/RM atipici

2003 ◽  
Vol 16 (3) ◽  
pp. 445-448
Author(s):  
E. Tedeschi ◽  
S. Cirillo ◽  
M.L. Del Basso De Caro ◽  
E. M. Covelli ◽  
G. Belfiore
Keyword(s):  
Anterior Part ◽  
Mass Effect ◽  
Neurofibromatosis Type ◽  
Cerebellar Hemisphere ◽  
Imaging Features ◽  
Neoplastic Tissue ◽  
Surgical Specimen ◽  
Diffusion Weighted Images ◽  
Water Diffusivity ◽  
Increased Risk

A 13 year-old boy, previously diagnosed as having Neurofibromatosis Type 1 (NF1) but otherwise healthy, was referred to our Department for headache, vomiting, ataxia and VI-VII left cranial nerve palsy. Emergency head CT scan was performed, immediately followed by contrast-enhanced MR scan with Echo-Planar (EPI) water diffusibility study. A large ovalar mass lesion was evident in the left cerebellar hemisphere, hyperdense on CT, hypointense in T2-weighted images, isointense to grey matter in FLAIR and T1-weighted images, with clear mass effect on the surrounding structures, but only mild peripheral contrast-enhancement in the anterior part of the mass, these features resembling those of a desmoplastic medulloblastoma. However, the EPI Diffusion-weighted images (DWI) and corresponding Apparent Diffusion Coefficient (ADC) maps consistently showed increased water diffusivity, a pattern not compatible with the dense cell-packing typical of medulloblastomas. The pathological analysis of the surgical specimen indeed showed focal neoplastic cell clusters interspersed in a diffusely altered cerebellar cortex. Neoplastic cells exhibited large eosinophilic cytoplasma, hyperchromatic and multinucleolated nuclei, and frequent mitoses, a pattern indicative of anaplastic astrocytoma. The case presented supports the evidence that NF1 is associated with increased risk of developing several different neoplasms, beside the well-known pilocytic astrocytomas of the optic pathway. As these neoplasms may exhibit misleading imaging features at CT or “conventional” MRI study, the assessment of water diffusivity may provide useful data for reaching a correct pre-operative diagnosis, since it reflects the histological architecture of the neoplastic tissue.

scholarly journals Pituitary Macroadenoma with Apoplexy in an Adult: A Case Report

2020 ◽  
Vol 2 (4) ◽  
pp. 189-197
Author(s):  
Fakhri Amin Nasution ◽  
Brama Ihsan Sazli
Keyword(s):  
Pituitary Adenomas ◽  
Incidental Finding ◽  
Mass Effect ◽  
Blurred Vision ◽  
Hyperintense Lesion ◽  
General Physical Examination ◽  
Mri Brain ◽  
History Of ◽  
Benign Tumours ◽  
General Physical

Abstract: Pituitary adenomas are the most common type and benign tumours arising from hormone expressing cells in the anterior pituitary gland. They account for 10% to 15% of all intracranial masses. Pituitary adenomas present clinically in three ways: syndromes of hormone hypersecretion or deficiency; neurologic manifestations from mass effect of an expanding gland; or an incidental finding on imaging done for an unrelated issue. A 49-years old man, was reffered to the hospital with symptoms of chronic headache and blurred vision. General physical examination revealed no abnormalities. History of previous illness and medication were unremarkable. MRI brain showed hyperintense lesion in suprasellar/selllar area. Hormone assay reciprocally revealed hypocortisolism and hyperprolactinemia. Abstrak: Adenoma hipofisis merupakan tumor jinak tersering dari sel penghasil hormon di kelenjar hipofisis anterior, berkisar 10%-15% dari seluruh massa intrakranial. Adenoma hipofisis secara klinis bermanifestasi dalam tiga cara: sindrom hipersekresi atau defisiensi hormon; manifestasi neurologis dari efek massa yang membesar; atau temuan secara tidak sengaja pada modalitas pencitraan. Seorang laki-laki berumur 49 tahun dirujuk ke rumah sakit dengan kkeluhan sakit kepala kronik dan pandangan kabur. Pemeriksaan fisik secara umum dalam batas normal. Riwayat penyakit sebelumnya atau pengobatan juga tidak spesifik. MRI otak menunjukkan lesi hiperintens pada area suprasellar/sellar. Temuan pemeriksaan hormon juga sejalan menunjukkan hipokortisolisme dan hiperprolaktinemia.

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.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Spontaneous Catheter Separation from the Implanted Venous Port and Its Migration to the Venous Heart: Clinical Case

2018 ◽  
Vol 5 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Lyudmila V. Olkhova ◽  
Vladimir E. Popov
Keyword(s):  
Clinical Case ◽  
Care Delivery ◽  
Venous Access ◽  
Cerebellar Hemisphere ◽  
Clinical State ◽  
Venous Port ◽  
Silicone Catheter ◽  
Oncological Diseases ◽  
Left Cerebellar Hemisphere ◽  
Port Systems

Background. Currently, vascular access is one of the most important aspects in specific and accompanying treatment of cancer patients regardless of their age and sex. Partially implanted venous catheters previously described by Hickman were widely applied all over the world. The introduction of completely implanted venous port-systems revolutionized health care delivery and improved the quality of life in patients with oncological diseases. A fully implanted venous port consists of a silicone catheter which distal tip is connected to a port tank implanted subcutaneously. Such a design allows providing safe and multiple adequate vascular accesses regardless of the patient’s clinical state.Case Report. We present a clinical case of a 10-year-old patient diagnosed with medulloblastoma of the cerebellopontine angle and the left cerebellar hemisphere. The case described spontaneous detachment of an implanted venous port catheter and its migration to the venous heart in a patient who underwent chemotherapy by venous access provided through implantation of the venous port.Conclusion. Our clinical case demonstrated a rare and potentially extremely dangerous noninfectious complication associated with the use of venous port-systems. Implanted systems require washing 1–2 times per month with heparinized solutions or solutions containing taurolidine when they are not used. Periodic chest radiographs can reveal integrity alterations of the system. Any implanted system should be removed when it is not used, or it should be monitored on a regular basis.

scholarly journals Concurrent Inverted Papilloma and Squamous Cell Carcinoma with Intradural Extension Presenting with Frontal Lobe Syndrome

2021 ◽  
Author(s):  
Abdul Jaleel ◽  
Pavithran V. M. ◽  
Shanavas Cholakkal ◽  
Vineeth Kadangot Kuthampulli
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Frontal Lobe ◽  
Squamous Cell ◽  
Benign Lesion ◽  
Lateral Wall ◽  
Inverted Papilloma ◽  
Intracranial Extension ◽  
Rare Presentation ◽  
Frontal Lobe Syndrome

Abstract Inverted papilloma is an uncommon tumor mostly arising from the lateral wall of the nasal cavity and displays a benign but locally aggressive behavior. Intracranial extension is an extremely rare presentation of inverted papilloma. Extension occurs either as a benign lesion or due to malignant transformation. We report a case of concurrent inverted papilloma and squamous cell carcinoma presenting with epistaxis and recent-onset altered behavior and memory impairment. After literature review of similar cases having inverted papilloma with intracranial extension, we could identify a total of 12 cases, most of which were recurrences of a primary inverted papilloma that were resected before extension into the cranial cavity. Most cases were of extradural extension, and intradural spread resulted in poor prognosis on follow-up. Concurrent inverted papilloma and squamous cell carcinoma extending into the anterior cranial fossa and frontal lobe is a very rare clinical entity and can present as frontal lobe syndrome.

Prolapsed Nasal Polyp Causing Acute Airway Obstruction: An Exceptional Presentation

ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Krupa R. Patel ◽  
Ashton E. Lehmann ◽  
Aria Jafari ◽  
Daniel L. Faden
Keyword(s):  
Airway Obstruction ◽  
Nasal Polyp ◽  
Nasal Polyposis ◽  
Upper Airway ◽  
Rare Presentation ◽  
First Case ◽  
Acute Airway Obstruction ◽  
History Of ◽  
Sinonasal Symptoms ◽  
Or History

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.

scholarly journals A Case of a Laryngeal MALT Lymphoma in a Patient with a History of Gastric MALT

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Mark Ashamalla ◽  
Marita S. Teng ◽  
Joshua Brody ◽  
Elizabeth Demicco ◽  
Rahul Parikh ◽  
...  
Keyword(s):  
African American ◽  
Malt Lymphoma ◽  
African American Woman ◽  
American Woman ◽  
Complete Response ◽  
Gastric Malt Lymphoma ◽  
Rare Presentation ◽  
Original Diagnosis ◽  
History Of ◽  
Previously Treated

We are reporting a case of a 62-year-old African American woman with a history of gastric MALT lymphoma successfully treated with radiation who presented with a laryngeal MALT lymphoma 4 years after her original diagnosis. She received definitive radiation with a complete response. The case presented is unique for the rare presentation of a MALT lymphoma in the larynx, especially in light of the patient’s previously treated gastric MALT lymphoma years ago.

scholarly journals Melioidosis: A Rare Cause of Liver Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Peter Franz M. San Martin ◽  
Catherine S. C. Teh ◽  
Ma. Amornetta J. Casupang
Keyword(s):  
Liver Abscess ◽  
Burkholderia Pseudomallei ◽  
Abdominal Ultrasound ◽  
Open Drainage ◽  
High Grade Fever ◽  
Rare Presentation ◽  
Culture Studies ◽  
Moderate Growth ◽  
Male Farmer ◽  
History Of

Case Presentation. This is a case of a 44-year-old male, farmer, known to be diabetic, presenting with two-week history of vague abdominal pain associated with high grade fever. Abdominal CT scan showed localized liver abscess at segment 8 measuring 7.5 × 6.8 × 6.1 cm. Patient subsequently underwent laparoscopic ultrasound guided pigtail insertion for drainage of abscess. Culture studies showed moderate growth ofBurkholderia pseudomalleiin which the patient completed seven days of IV Meropenem. On follow-up after 12 weeks of oral Sulfamethoxazole/Trimethoprim, taken twice a day, the patient remained asymptomatic with no residual findings based on the abdominal ultrasound.Discussion. Diagnosis of melioidosis, a known “great masquerader,” relies heavily on culture studies. Consensus with regard to the management of liver abscess caused byBurkholderia pseudomalleihas not yet been established due to the rarity of cases. Surgical intervention through either a percutaneous or open drainage has shown good outcomes compared to IV antibiotics alone. In Philippines, the possibility of underreporting is highly plausible. This write-up serves not only to report a rare presentation of melioidosis but also to add to the number of cases reported in the country, possibly indicative of disease emergence.

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