Retinal detachment and convexity intracranial meningioma: an uncommon association.

CASE REPORT: A 70-years-old woman presented with a one week history of progressive loss of vision in the right eye (RE) diagnosed as retinal detachment from 7 to 1 o' clock with retinal break at the 10.30 o' clock associated. Gadolinium enhanced magnetic resonance imaging (MRI) scan of the brain and orbits with fat suppression showed a convexity meningioma. Scleral buckling with a segmental sponge, subretinal fluid drainage and cryopexy were performed with detachment repair. CONCLUSION: In our patient with retinal detachment and convexity meningioma without significant neurological symptoms, performing ocular surgery and close follow up care seemed to be the optimal treatment option.

Solitary Langerhans cell histiocytosis orbital lesion: case report and review of the literature.

Solitary eosinophilic granuloma is a rather benign and localized form of Langerhans's cell histiocytosis. Definitive diagnosis is made by histopathology including immunohistochemical detection of S-100, HLA-DR and CD1a antigens. We report the case of a twenty-five year old boy presented with headache and orbit's pain. A CT scan showed a left supero-lateral orbital mass with evidence of bone erosion. The different options of treatment are discussed and the literature is reviewed.

Solitary Langerhans cell histiocytosis orbital lesion: case report and review of the literature

Solitary eosinophilic granuloma is a rather benignand localized form of Langerhans's cell histiocytosis.Definitive diagnosis is made by histopathology including immunohistochemical detection of S-100, HLA-DR andCD1a antigens. We report the case of a twenty-five year old boy presented with headache and orbit's pain. ACT scan showed a left supero-lateral orbital mass with evidence of bone erosion. The different options of treatment are discussed and the literature is reviewed (AU)

El granuloma solitario eosinófilo es un tumor normalmente benigno y es una forma localizada de la hisitiocitosis de las células de Langerhans. La diagnosis definitiva viene de un estudio histopatológico incluida labúsqueda con métodos inmunohistoquímicos de S-100,HLA-DR y de los antígenos CD1a. Proponemos el casode un joven de venticinco años que presentaba dolor de cabeza y dolor de una órbita. Una TAC muestra unamasa en sede orbital supra-lateral izquierda con unaevidencia de erosión del hueso. Se discuten las diferenteselecciones de tratamiento y se revisa la bibliografia (AU)

A case of Capnocytophaga canimorsus brain abscess secondary to dog's bite.

Capnocytophaga canimorsus has been recognized as an opportunistic pathogen causing systemic infections in immunocompromised individuals. It is part of the normal oral flora of the dog, and can be responsible for localized wound infections in humans in consequence of bites. This microorganism causes also septicemia, meningitis, endocarditis, ocular infections and rarely brain abscess. We describe the case of an immunocompetent 28-year-old male with temporal brain abscess from Capnocytophaga canimorsus secondary to dog's bite.

Brain abscess and Rendu-Osler-Weber disease. Case report and review of the literature.

The case of a 51-year-old man presented with intermittent diplopia, headache and family history of Rendu-Olser-Weber disease , also defined heredirary hemorrhagic telangiectasia (HHT), is described. Magnetic resonance imaging of the brain revealed an enhancing right occipital mass with surrounding edema. Computerized tomography of the chest identified pulmonary arteriovenous fistlae. The physiopathology of HHT and the treatment of the cerebral lesions are discussed.

Posterior fossa acute subdural haematoma following anticoagulant therapy. Case report.

A case of acute subdural haematoma of the posterior fossa in an alive adult secondary to anticoagulant therapy is described. The clinical presentation and the final decision of conservative management are discussed and the literature is reviewed.

Brain abscess following dental procedures. Case report.

There have been a number of reports of brain abscess suggesting an odontogenic etiology after dental treatment procedures or oral infections, but the diagnosis was mainly by exclusion rather than based on evidence. We present a case of a brain abscess due to Strepto-coccus constellatus in a 27-year-old-immunocompetent woman who underwent extraction of the primary molar and eradication of a radicular cyst some weeks before.

Coats disease: smaller volume of the affected globe.

PURPOSE: To determine whether a significant smaller volume of the affected globe, compared with that of the normal globe, is an additional feature of Coats disease. MATERIALS AND METHODS: Ocular globe volume was assessed in 13 children (11 boys, two girls; age range, 0.6-14 years; mean age, 4.1 years) with Coats disease and in 18 (eight boys, 10 girls; age range, 0.5-12 years; mean age, 3.6 years) with unilateral retinoblastoma. Orbital computed tomographic scans were available for all children; magnetic resonance images were available for 11 children-seven with Coats disease and four with retinoblastoma. For volume estimation, anteroposterior and equatorial diameters of ocular globes were measured. Statistical analysis was conducted with univariate and multivariate methods. RESULTS: In children with Coats disease, the mean volume of the affected globe was 4,877.03 mm(3) (range, 2,951.47-6,284.70 mm(3)) and that of the normal globe, 6,018.00 mm(3) (range, 4,062.32-7,509.26 mm(3)). In children with retinoblastoma, the mean volume of the affected globe was 4,557.06 mm(3) (range, 1,612.01-7,463.00 mm(3)) and that of the normal globe, 4,402.11 mm(3) (range, 1,360.46- 7,463.00 mm(3)). The Coats disease population had a significantly smaller volume of the affected globe (z = -3.1009; P =.002); the retinoblastoma population did not have a statistically significant trend toward a bigger affected globe volume (z = -1.7064; P =.088). The difference between the affected globe volume and the normal globe volume in children with Coats disease was the only significant independent variable (P =.005). CONCLUSION: A significantly smaller volume of the affected globe is an additional feature of Coats disease.

MRI of Wolfram syndrome (DIDMOAD).

Wolfram syndrome (DIDMOAD) is a rare diffuse neurodegenerative disorder characterised by diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and a wide variety of abnormalities of the central nervous system, urinary tract and endocrine glands. It may be familial or sporadic. Reported features on MRI of the brain are absence of the physiological high signal of the posterior lobe of the pituitary, shrinkage of optic nerves, chiasm and tracts, atrophy of the hypothalamic region, brain stem, cerebellum, and cerebral cortex. We report a 12-year-old girl with a 5-year history without brain stem, cerebellar or cerebral atrophy. MRI showed an unusual feature: a focus of high signal on PD- and T2-weighted images in the right substantia nigra. This is consistent with previously reported neuropathological post-mortem studies, but has never been reported in vivo.

Central diabetes insipidus with spontaneous remission. A case report.

We report a case of central diabetes insipidus with spontaneous remission 8 months after clinical beginning of the disease. A 20 years-old man developed polydipsia and polyuria in October 1994. A water deprivation study showed a defect in the urine concentrating function, which was corrected by vasopressine. A Magnetic Resonance imaging of the skull revealed a thickening of the pituitary stalk. His condition was well controlled by nasal DDAVP administration and 6 months later patient reduced spontaneously medication dose without clinical worsening. 8 months after clinical beginning, patient has become completely free from the need for medication to control clinical symptoms and urine concentrating function, as demonstrated by a re-evaluation study with water deprivation. A control Magnetic Resonance showed the regression of stalk enlargement. The clinical and radiological features of this case are discussed.

Posterior circulation infarcts in patients with vertebrobasilar dolichoectasia.

BACKGROUND AND PURPOSE: Vertebrobasilar dolichoectasia (VBD) may produce symptoms by direct compression of cranial nerves or the brain stem, by obstructive hydrocephalus, or by ischemia in the vertebrobasilar arterial territory. This study was undertaken to examine and characterize clinical and imaging findings in patients with stroke associated with VBD and compare these data with those for patients with VBD who did not have a stroke. METHODS: We studied 40 consecutive stroke patients with associated VBD. All were evaluated by CT scan (n=9), MRI (n=6), or both (n=25). The diameter of the basilar artery (BA), height of bifurcation, and transverse position were evaluated. Clinical and imaging findings were compared with those found in a group of 40 VBD patients without stroke. RESULTS: More than half of the patients (24 of 40) had infratentorial infarcts, located mainly in the midpons. Sixteen patients had supratentorial lesions localized in the thalamus (n=8) or in the superficial arterial territory of the posterior cerebral artery (PCA; n=8). The diameter and height of the bifurcation of the BA were correlated with the location of the lesion (PCA territory versus BA territory), in that severe ectasia and vertical elongation of the BA were significantly more often observed in patients with infarcts in PCA territory than in patients with infarcts in territories supplied by branches of the BA. Comparison of VBD patients with and without stroke showed that the incidence of arterial hypertension and the degree of ectasia and lateral displacement of the BA were not significantly different in the two groups. Patients with stroke more often had atherosclerotic changes of the posterior circulation (P=.0006) and a higher degree of vertical elongation of the BA (P=.025). CONCLUSIONS: In patients with VBD, superimposed atheromatous changes of the posterior circulation may have an important role in precipitating ischemia. However, other factors related to the severity of the dolichoectasia also favor ischemia and in some cases are the only factors responsible.

Cerebrotendinous xanthomatosis (van Bogaert-Scherer-Epstein disease): CT and MR findings.

PURPOSE: To describe the CT and MR findings in the brain and spinal cord of patients with cerebrotendinous xanthomatosis and to seek possible correlations between clinical, biochemical (cholestanol levels), and neuroimaging findings. METHODS: Ten patients with well-defined clinical and biochemical diagnoses of cerebrotendinous xanthomatosis were examined. Brain CT was performed in eight cases. In all patients MR was obtained using spin-echo and gradient-echo sequences. In eight patients spine MR was also performed. RESULTS: Neuroradiologic findings included diffuse cerebral and cerebellar atrophy. In half the cases, atrophy of the brain stem and corpus callosum was also found. In the majority of patients cerebellar bilateral focal lesions and mild white matter signal alterations were present. Spinal cord MR did not show signal abnormalities or atrophy. CONCLUSIONS: We found cranial alterations in patients with severe neurologic impairment, but there was no correlation with cholestanol plasma levels. No spinal cord abnormalities were present.

Arachnoid cysts of the middle cranial fossa: a clinical, radiological and follow-up study.

Twenty-seven patients with CT-scan-diagnosed arachnoid cysts in the middle cranial fossa were studied. Five (18%) presented with progressive symptoms related to raised intracranial pressure which had developed after minor trauma and secondary bleeding, 12 (44%) presented with non-progressive symptoms, and 10 (37%) exhibited neurological syndromes not referable to the cyst. Among those with non-progressive symptoms, epilepsy was the most common presentation (67%). More than 60% of the cysts were small and limited to the anterior temporal region or to the Sylvian fissure, the remaining cysts involved both the anterior temporal region and the Sylvian fissure, and expanded to the adjacent fronto-temporal or fronto-parietal regions. The volume measurements of the brain tissue performed on CT scan revealed that between the volume of the two hemispheres there was no significant difference suggesting any evidence of agenesis or hypoplasia of the affected temporal lobe.