Assuntos
Adenoma Pleomorfo , Recidiva Local de Neoplasia , Neoplasias Parotídeas , Adenoma Pleomorfo/diagnóstico por imagem , Adenoma Pleomorfo/radioterapia , Adenoma Pleomorfo/cirurgia , Adulto , Feminino , Humanos , Recidiva Local de Neoplasia/diagnóstico por imagem , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/cirurgia , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/radioterapia , Neoplasias Parotídeas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Low- and middle-income countries (LMIC) have suffered from long-term health system deficiencies, worsened by poor living conditions, lack of sanitation, a restricted access to health facilities and running water, overcrowding, and overpopulation. These factors favor human displacement and deepen marginalization; consequently, their population endures a high burden of infectious diseases. In this context, the current epidemiological landscape and its impact on health and economic development are not promissory, despite the commitment by the international community to eradicate neglected tropical infections - especially tuberculosis and malaria, by 2030. Neglected and (re)-emerging infectious diseases affecting the central nervous system (CNS) are a major public health concern in these countries, as they cause a great morbidity and mortality; furthermore, survivors often suffer from severe neurological disabilities. Herein, we present a retrospective review focused on some neglected and (re)-emerging infectious diseases, including neurocysticercosis, malaria, rabies, West Nile virus encephalitis, tuberculosis, neuroborreliosis, and SARS-CoV-2 in LMIC. A retrospective review of studies on selected neglected and (re)-emerging infectious diseases in LMIC was performed, including reports by the World Health Organization (WHO) published within the last five years. Data on infection by SARS-CoV-2 were provided by the John Hopkins University Coronavirus Resource Center. CNS neglected and (re)-emerging infectious diseases remain as important causes of disease in LMIC. An alarming increase in the prevalence of malaria, tuberculosis, and cysticercosis is observed in the region, compounded by the recent COVID-19 pandemic. The WHO is currently supporting programs/efforts to cope with these diseases. Herein, we highlight the epidemiological burden of some CNS infections in LMIC, and their clinical and neuroimaging features, to facilitate an accurate diagnosis, considering that most of these diseases will not be eradicated in the short term; instead, their incidence will likely increase along with poverty, inequality, and related socioeconomic problems.
RESUMO
A case of a 32-year-old female with a known diagnosis of Turner syndrome who presented with complaints of chronic progressive right-sided facial pain and sinus pressure and who was afebrile. On physical examination, there was eye proptosis on the right and significant increased fullness in the right infraorbital and maxillary regions. Computed tomography and magnetic resonance imaging demonstrated a large expansile space-occupying lesion in the right maxillary area that histologically turned out to be a giant cell reparative granuloma. The lesion was completely removed, and of interest, the patient was followed up both clinically and on imaging for 10 years with no signs of recurrence. A discussion on this entity, as well the clinical and imaging differential diagnoses, is discussed.
Assuntos
Granuloma de Células Gigantes/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Seio Maxilar/patologiaRESUMO
This is a case of a 32-year-old female with a known diagnosis of Turner syndrome who presented with complaints of chronic progressive right-sided facial pain and sinus pressure, and who was afebrile. On physical examination, there was eye proptosis on the right and significant increased fullness in the right infraorbital and maxillary regions. Computed tomography and magnetic resonance imaging demonstrated a large expansile space-occupying lesion in the right maxillary area, that histologically turned out to be a giant cell reparative granuloma. The lesion was completely removed and of interest, the patient was followed up both clinically and on imaging for 10 years with no signs of recurrence. A discussion on this entity, as well the clinical and imaging differential diagnoses, is carried out.
Assuntos
Granuloma de Células Gigantes/diagnóstico por imagem , Doenças Maxilares/diagnóstico por imagem , Adulto , Exoftalmia/etiologia , Feminino , Seguimentos , Granuloma de Células Gigantes/complicações , Granuloma de Células Gigantes/cirurgia , Humanos , Imageamento por Ressonância Magnética , Doenças Maxilares/complicações , Doenças Maxilares/cirurgia , Tomografia Computadorizada por Raios X , Síndrome de Turner/complicaçõesAssuntos
Hospedeiro Imunocomprometido , Nocardiose/diagnóstico , Osso Parietal/microbiologia , Músculo Temporal/microbiologia , Infecções por Treponema/diagnóstico , Adulto , Medula Óssea/diagnóstico por imagem , Medula Óssea/microbiologia , Coinfecção , Abscesso Epidural/diagnóstico por imagem , Infecções por HIV/imunologia , Humanos , Masculino , Nocardiose/diagnóstico por imagem , Osso Parietal/diagnóstico por imagem , Abuso de Substâncias por Via Intravenosa/imunologia , Músculo Temporal/diagnóstico por imagem , Infecções por Treponema/diagnóstico por imagemAssuntos
Malformações Vasculares do Sistema Nervoso Central/complicações , Espasmo Hemifacial/etiologia , Síndromes de Compressão Nervosa/etiologia , Artéria Vertebral/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Nervo Facial , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/diagnóstico por imagemRESUMO
Osmotic demyelination syndrome (ODS) is a general term that has become commonplace in the practice of medicine, encompassing both central pontine myelinolysis and extrapontine myelinolysis. Historically ODS arises as a serious complication of rapid correction of hyponatremia, yet its manifestations seem to be influenced by a multifactorial process. Further understanding of this rare demyelinating disease has elucidated the significant role of other electrolyte disturbances and the presence of chronic comorbidities as disease risk factors. This review discusses the current research regarding the pathophysiology, clinical manifestations, neuroimaging features, patient management, and prognosis of osmotic demyelination syndrome. We hope that this review will further endorse and aid in the proper diagnosis of ODS and its suitable management through the understanding of clinical and imaging correlations and outcomes, and the comorbid factors that may predispose the development of ODS in certain patient populations.
Assuntos
Comorbidade , Hiponatremia/tratamento farmacológico , Imageamento por Ressonância Magnética/métodos , Mielinólise Central da Ponte/diagnóstico por imagem , Terapia Combinada , Feminino , Escala de Coma de Glasgow , Humanos , Hiponatremia/diagnóstico , Incidência , Masculino , Pessoa de Meia-Idade , Mielinólise Central da Ponte/mortalidade , Mielinólise Central da Ponte/fisiopatologia , Mielinólise Central da Ponte/terapia , Neuroimagem/métodos , Prognóstico , Índice de Gravidade de Doença , Taxa de Sobrevida , SíndromeRESUMO
A 39 year-old male with a history of diabetes, retinitis pigmentosa, and genital warts presented with intractable occipital headaches accompanied with nausea and vomiting. The patient had markedly depressed CD4 counts. Furthermore the patient tested negative for HIV and HTLV 1/2 and had normal immunoglobulin levels. During hospital course the patient underwent a lumbar puncture and multiple imaging exams, including both CT and MR. Except for occasional nausea and vomiting controlled by therapeutic lumbar punctures, phenergan, and dilaudid the patient's hospital course was uncomplicated.
Assuntos
Abscesso Encefálico/diagnóstico por imagem , Hospedeiro Imunocomprometido , Meningite Criptocócica/diagnóstico por imagem , T-Linfocitopenia Idiopática CD4-Positiva/diagnóstico por imagem , T-Linfocitopenia Idiopática CD4-Positiva/imunologia , Adulto , Antifúngicos/uso terapêutico , Abscesso Encefálico/fisiopatologia , Abscesso Encefálico/terapia , Terapia Combinada , Seguimentos , Humanos , Hidromorfona/uso terapêutico , Interleucina-2/uso terapêutico , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Masculino , Meningite Criptocócica/fisiopatologia , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/etiologia , Prometazina/uso terapêutico , Doenças Raras , Medição de Risco , Punção Espinal/métodos , T-Linfocitopenia Idiopática CD4-Positiva/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
A 56 year old African-American man presented to the emergency department with dyspnea and dysphagia with drooling. On his initial evaluation, disproportionate obesity of the face, neck and shoulders were noted. The patient's history was significant for obstructive sleep apnea, end-stage renal disease, alcoholic liver disease, pulmonary hypertension and alcoholic cardiomyopathy. He had multi-decade history of heavy alcohol abuse, but quit drinking two years previously.
Assuntos
Alcoolismo/complicações , Lipomatose Simétrica Múltipla/diagnóstico por imagem , Humanos , Lipomatose Simétrica Múltipla/etiologia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Few cases of primary mucosal melanoma of the larynx have been documented in the literature, so only a limited amount of data exists regarding its diagnosis and treatment. The prognosis is poor, as patients often present at a late stage with regional or distant metastases. We describe the case of a 66-year-old man who presented with hoarseness and dysphagia. Laryngoscopy identified a dark discoloration of the supraglottic larynx and incomplete mobility of the right vocal fold; an excisional biopsy confirmed the diagnosis. We discuss the epidemiology, clinical features, diagnosis, interpretation of imaging findings, and management of this rare malignant melanoma.
Assuntos
Neoplasias Laríngeas/patologia , Melanoma/patologia , Idoso , Transtornos de Deglutição/etiologia , Rouquidão/etiologia , Humanos , Mucosa Laríngea/patologia , Neoplasias Laríngeas/complicações , Masculino , Melanoma/complicações , Doenças RarasRESUMO
A 71 year-old female with a past medical history significant for hypertension, hyperlipidemia, diabetes, and strokes, presented initially to the stroke service with a sudden onset of right facial droop, right-sided weakness, dysarthria, and seizures that had gotten progressively worse for six weeks.
Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Neuroepiteliomatosas/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Acidente Vascular Cerebral/etiologiaRESUMO
Fungal infections of the central nervous system (CNS) pose a threat to especially immunocompromised patients and their development is primarily determined by the immune status of the host. With an increasing number of organ transplants, chemotherapy, and human immunodeficiency virus infections, the number of immunocompromised patients as susceptible hosts is growing and fungal infections of the CNS are more frequently encountered. They may result in meningitis, cerebritis, abscess formation, cryptococcoma, and meningeal vasculitis with rapid disease progression and often overlapping symptoms. Although radiological characteristics are often nonspecific, unique imaging patterns can be identified through computer tomography as a first imaging modality and further refined by magnetic resonance imaging. A rapid diagnosis and the institution of the appropriate therapy are crucial in helping prevent an often fatal outcome.
RESUMO
An MRI of the brain and spine of an 11-year-old male revealed the following abnormality which is consistent with his chronic condition.