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Case Rep Pediatr ; 2021: 6670585, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34616579


Pilomyxoid astrocytoma (PMA) is a freshly described figure of low-grade neoplasms encountered in early childhood. Nevertheless, its precise classification by the World Health Organization (WHO) is still debatable. Making an exact diagnosis relies on histological and immunohistochemical pathognomonic features with specific radiological findings. PMA behaves aggressively with a shorter progression-free survival, and its management is unfortunately still arguable. We describe a rare case of PMA involving the suprasellar region who displays symptoms consistent with diencephalic syndrome. The diagnosis was made by magnetic resonance imaging (MRI) focused on the hypothalamic-pituitary axis, and the patient underwent a subtotal tumor resection combined with chemotherapy. Diagnosis of brain tumors should be kept in mind in young children with generalized and severe unexplained loss of subcutaneous fat with failure to thrive after ruling out classical causes.

Surg Neurol Int ; 12: 304, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34345445


Background: Hypophysitis is described as a rare chronic inflammatory affection of the pituitary gland. However, to date, its pathogenesis has not been completely cleared up. Clinical features are polymorphic, including symptoms related to inflammatory compression and/or hypopituitarism. Laboratory tests determine hormone deficiencies orientating replacement therapy's protocol. MRI of the hypothalamic-pituitary region is crucial in exhibiting major radiological signs such as pituitary homogeneous enlargement and gland stalk's thickening. The etiological diagnosis is still challenging without affecting the management strategy. Corticosteroids have widely been used but a close follow-up without any treatment has also been approved. Case Description: In this report, seven patients with hypophysitis have been collected over a period of 6 years. The average age of our patients was 32.1 years ± 11.8 with a female predominance (71.4%). Panhypopituitarism was objective in 42.9% of cases, a combined deficiency of the hypothalamic-pituitary thyroid, adrenal and gonadal axes in 28.6% of cases. A central diabetes insipidus was noted in 42.9% of the patients. Idiopathic hypophysitis was the most common etiology. The use of long course corticosteroids was required in 28.6% when compressive signs were reported. Conclusion: Hypophysitis remains a rare disease with nonspecific clinical and radiological patterns. Autoimmune origin seems to be the most frequent etiology. No guidelines have been established for hypophysitis management and the evolution is still unpredictable.

Pan Afr Med J ; 38: 123, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33912293


This study reports the case of a 45-year-old female patient who underwent brain CT scan which fortuitously revealed de novo lesion. She was diagnosed with left isodense intradiploid lesion in the pterional region with bone lysis uniformly enhancing after injection of contrast medium. Magnetic resonance imaging showed T1-weighted hypointense lesion, spontaneously hyperintense signal on T2-weighted images and FLAIR images, strongly enhancing after gadolinium injection. Total tumor excision was performed. Histological examination showed chordoid meningioma.

Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Feminino , Gadolínio/administração & dosagem , Humanos , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/cirurgia , Meningioma/patologia , Meningioma/cirurgia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
Pediatr Neurosurg ; 56(1): 50-55, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33550309


INTRODUCTION: Intracranial arachnoid cysts (ACs) are space-occupying lesions that typically remain stable in size and clinically silent over time. CASE REPORT: We describe an unusual pediatric case of enlarged AC impressive by its compressive phenomena. An 11-month-old girl presented with remarkable macrocephaly associated with a cystic orbital tumor. CT scan and MRI studies revealed a large intracranial ACs extending in the orbit with an orbital meningocele (OM). The intracranial cyst did communicate with the orbital one into a bony defect in the right inner region of the orbital roof and represses the globe outward. A cystoperitoneal shunting procedure was performed to remove the mass effect as soon as possible and facilitate normal development. DISCUSSION/CONCLUSION: Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Classically described complications result from compression of adjacent structures and include focal neurologic involvement, headaches and seizures and developmental deficits, or macrocephaly in younger children. There are few cases of ACs with ophthalmic manifestations reported in the literature. The paucity of literature prompted us to analyze the case. To the best of our knowledge, an AC accompanying OM has not been reported. The pathogenesis and management of the case will be discussed.

Cistos Aracnóideos , Meningocele , Meningomielocele , Adulto , Cistos Aracnóideos/complicações , Cistos Aracnóideos/diagnóstico por imagem , Cistos Aracnóideos/cirurgia , Criança , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Meningocele/complicações , Meningocele/diagnóstico por imagem , Meningocele/cirurgia , Tomografia Computadorizada por Raios X
Spinal Cord Ser Cases ; 6(1): 56, 2020 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-32606288


INTRODUCTION: Neurosyphilis is a sexually transmitted disease secondary to the invasion of the central nervous system by the Treponema pallidum. The spinal syphilitic gumma is rare. CASE PRESENTATION: We report a case of extradural cervical spinal syphilitic gumma revealed by spinal cord compression in a 58-year-old male. The epidural lesion was removed via a posterior approach. Histological examination revealed syphilis. Syphilis serologies were positive. Brain MRI showed an associated cerebro-meningeal syphilitic gumma. Antibiotic regime based on aqueous penicillin G was introduced for 14 days. DISCUSSION: Currently, there is an increase in the frequency of syphilis and changes in its clinical manifestations. Neurosyphilis can take atypical forms. Spinal syphilitic gumma is a rare manifestation and its association with cerebral involvement is exceptional. Diagnosis is based on serologies in the blood and cerebrospinal fluid. The place of imagery, especially magnetic resonance imaging, is essential. Neurosyphilis should be discussed as a possible differential diagnosis in evaluation of spinal and cerebral lesions.

Neurossífilis/complicações , Compressão da Medula Espinal/complicações , Compressão da Medula Espinal/patologia , Sífilis/patologia , Antibacterianos/uso terapêutico , Vértebras Cervicais/patologia , Vértebras Cervicais/fisiopatologia , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neurossífilis/diagnóstico , Neurossífilis/terapia , Compressão da Medula Espinal/diagnóstico , Sífilis/diagnóstico
Pan Afr Med J ; 33: 194, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692738


Mass lesions of the brain are not always a tumor. We report the case of a patient followed for Behcet syndrome presenting with expansive intracranial process revealed by right hemiparesis associated with signs of intracranial hypertension. Brain magnetic resonance imaging (MRI) showed a lesion suggesting glial tumor. Clinical and radiological assessments as well as laboratory tests helped to establish the diagnosis of pseudo-tumor form of neuro-Behçet disease. This study report is followed by a clinical analysis based on the available literature on this disorder.

Síndrome de Behçet/diagnóstico , Neoplasias Encefálicas/diagnóstico , Pseudotumor Cerebral/diagnóstico , Síndrome de Behçet/complicações , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade