ABSTRACT
Arachnoid cysts are collections of cerebrospinal fluid within the arachnoid membrane. They are benign lesions and most are congenital. They are usually asymptomatic; however, they can bleed and become symptomatic. Although arachnoid cyst associated to intracystic hemorrhage and spontaneous subdural hematoma is an uncommon complication, it is a well-known indication for emergency neurosurgery. We present the findings in a ten-year-old boy diagnosed with arachnoid cyst complicated by intracystic hemorrhage and spontaneous subdural hematoma diagnosed by magnetic resonance.
Subject(s)
Arachnoid Cysts/complications , Arachnoid Cysts/diagnosis , Cerebral Hemorrhage/diagnosis , Cerebral Hemorrhage/etiology , Hematoma, Subdural, Intracranial/diagnosis , Hematoma, Subdural, Intracranial/etiology , Magnetic Resonance Imaging , Child , Humans , MaleABSTRACT
El meningioma primario de la vaina del nervio óptico es un tumor raro, cuyo manejo diagnóstico yterapéutico ha variado de manera sustancial en los últimos años. La aparición y desarrollo de las técnicas dediagnóstico por imagen, como son la Tomografía Computerizada de Alta Resolución y la ResonanciaMagnética Nuclear, han permitido diagnósticos más precoces y precisos.La introducción de la Radioterapia Convencional (RT) a finales de los años 70, sola o en combinación conla cirugía, pero sobre todo la introducción de la Radioterapia Extereotáxica Fraccionada (RTEF) y laRadioterapia Conformacional Tridimensional (RTC3D), ha supuesto una alternativa terapéutica sumamenteeficaz y con una toxicidad relativamente baja.En este artículo revisamos en primer lugar el desarrollo embriológico, anatomía, la historia natural, eltratamiento quirúrgico, así como el papel de la RT en esta entidad, y su integración en el patrón de cuidadosactual. Analizamos las diferentes técnicas radioterápicas desde las más elementales como la RadioterapiaConvencional (RT), siguiendo con la Radioterapia Conformada 3 D (RTC3D), hasta las más sofisticadas comola Radioterapia Exterotáxica Fraccionada (RTEF), todo ello a propósito de nuestra experiencia en un caso
Primary optic nerve sheat meningioma (ONSM) is a rare tumor, whose diagnosis and therapeuticmanagement have varied in a substantial manner over the last few years. The appearance and development ofdiagnostic imaging techniques such as High Resolution Computerized Tomography and Nuclear MagneticResonance have allowed earlier and more precise diagnoses.The introduction of conventional radiation therapy in the late 1970s, alone or in combination with surgery,and above all the introduction of Fractionated Stereotactic Radiotherapy and Three-Dimensional ConformalIntensity-Modulated Radiotherapy (3DCRT) have provided very efficient alternative therapies with arelatively low toxicity.In this article we first review the embryological development, anatomy, natural history, and surgicaltreatment, and then describe the role of radiotherapy (RT) in the considered entity, indicating how it can beintegrated in the pattern of present day care.We analyse the different radiotherapy techniques, from the most elementary, such as conventional RT,followed by 3DCRT up to the most sophisticated such as Stereotactic Fractionated Radiotherapy, all based onour experience in one case
Subject(s)
Female , Middle Aged , Humans , Meningioma/radiotherapy , Optic Nerve Neoplasms/radiotherapy , Radiotherapy, Conformal/methods , Stereotaxic TechniquesSubject(s)
Arnold-Chiari Malformation/complications , Cluster Headache/etiology , Syringomyelia/complications , Adult , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/pathology , Decompression, Surgical , Female , Foramen Magnum/pathology , Foramen Magnum/surgery , Humans , Magnetic Resonance Imaging , RadiographyABSTRACT
Two cases of idiopathic tumoral calcinosis presenting as an extradural mass are reported. There are few reports in the literature of this pathological process presenting as extradural masses, so both cases represent very unusual locations for tumoral calcinosis. Magnetic resonance imaging features and pathological correlation of these two cases are presented. Tumoral calcinosis might be considered as a rare but possible cause of extradural mass.
Subject(s)
Calcinosis/diagnosis , Magnetic Resonance Imaging , Spinal Diseases/diagnosis , Calcinosis/pathology , Humans , Male , Middle Aged , Spinal Diseases/pathologyABSTRACT
Insulinomas are pancreatic neoplasms that can be radiologically characterized typically because of their tendency to present intense and early contrast enhancement with a wash-out phenomenon. In this sense, we report an unusual case of a hypovascular solid pancreatic insulinoma confirmed with surgery and pathologic analysis, in a patient with normal serum insulin levels. In the two-phase helical CT, the mass behaved as a hypodense lesion with respect to the surrounding pancreatic parenchyma during the arterial phase and as a hypointense lesion during the dynamic contrast-enhanced MR imaging. Pathologic examination demonstrated a hypercellular tumor with poor vascularization of intervening stroma which showed prominent amyloid deposits.
Subject(s)
Image Enhancement , Insulinoma/diagnosis , Magnetic Resonance Imaging , Pancreatic Neoplasms/diagnosis , Tomography, X-Ray Computed , Aged , Angiography , Female , Humans , Insulinoma/blood supply , Insulinoma/pathology , Pancreas/blood supply , Pancreas/pathology , Pancreatic Neoplasms/blood supply , Pancreatic Neoplasms/pathology , Predictive Value of TestsABSTRACT
OBJECTIVE: To characterize the clinical phenotype of LGMD2C in gypsies. BACKGROUND: Limb-girdle muscular dystrophy (LGMD) in gypsies of Western Europe is caused by a homozygous C283Y mutation on the same haplotype, suggesting a founder effect. METHODS: We performed clinical, laboratory, and muscle imaging studies of 40 patients. RESULTS: Mean age at onset was 5.3 years. One half of the patients had loss of ambulation by the age of 12; 13% still could walk after age 16. Calf hypertrophy, scapular winging, macroglossia, and lumbar hyperlordosis were common. Girdle, trunk, and proximal limb flexor muscles had earlier and more severe involvement. Cardiomyopathy was not observed. Five patients in the third decade of life required mechanical ventilation. Scoliosis was common in the nonambulatory stage. CONCLUSIONS: LGMD2C in gypsy patients with C283Y mutation presents a rather homogeneous phenotype, characterized by an initial Duchenne-like progressive course followed by a more prolonged survival rate possibly due to the absence of early respiratory impairment and cardiac failure.
Subject(s)
Cytoskeletal Proteins/genetics , Membrane Glycoproteins/genetics , Muscular Dystrophies/genetics , Roma , Adolescent , Adult , Age of Onset , Child , Child, Preschool , Female , Humans , Male , Muscles/pathology , Muscles/physiopathology , Muscular Dystrophies/pathology , Muscular Dystrophies/physiopathology , Mutation/genetics , PhenotypeABSTRACT
Granular cell tumor is a rare neoplasm arising within the neurohypophysis. We describe the MR imaging findings in two symptomatic patients. In one patient with history of panhypopituitarism, MR images showed a large sellar and suprasellar mass. The other patient presented with acute loss of vision in her left eye, and MR images showed a suprasellar mass with compression of the optic chiasm.
Subject(s)
Granular Cell Tumor/diagnosis , Magnetic Resonance Imaging , Pituitary Gland, Posterior , Pituitary Neoplasms/diagnosis , Female , Granular Cell Tumor/surgery , Humans , Male , Middle Aged , Pituitary Neoplasms/surgeryABSTRACT
A case of left atrial myxoma presenting exclusively with neurological symptoms, studied with magnetic resonance imaging (MRI) combined with cerebral angiography and computed tomography (CT) is reported. Typical angiographic findings suggested the diagnosis of myxoma. MRI showed multiple ischemic lesions disseminated throughout the entire brain, some of which had been clinically asymptomatic. Because of its sensitivity in identifying small cerebral infarcts, MRI should prove in the future to be a first-choice technique in the evaluation of the presence of and extent of cerebral involvement in embolic left atrial myxoma.