CEREBELLAR CRYPTOCOCCOMA IN A PATIENT WITH UNDIAGNOSED SARCOIDOSIS

Neurosurgery ◽  
2007 ◽  
Vol 60 (3) ◽  
pp. E571-E571 ◽  
Author(s):  
Charles W. Kanaly ◽  
Lee A. Selznick ◽  
Thomas J. Cummings ◽  
D. Cory Adamson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Tumor ◽  
Clinical Signs ◽  
Pulmonary Nodules ◽  
Underlying Disease ◽  
Pathological Examination ◽  
Resected Specimen ◽  
Predisposing Factor ◽  
History Of

Abstract OBJECTIVE We describe a patient with undiagnosed sarcoidosis who presented with a rare isolated cerebellar cryptococcoma masquerading as a metastatic brain tumor. CLINICAL PRESENTATION A 58-year-old man with a history of resected squamous cell carcinoma of the larynx and pulmonary nodules was found to have a left cerebellar lesion on neuroimaging after presenting with a 4-month history of occipital headaches. Neuroimaging revealed a large, lobulated, intra-axial, left cerebellar hemispheric mass with peripheral nodular enhancement, mild adjacent edema, and dense focal areas of calcification. INTERVENTION The patient underwent a left suboccipital craniotomy for gross total resection of the left cerebellar mass. Pathological examination of the resected specimen demonstrated a cryptococcoma, which was confirmed with a positive cerebrospinal fluid cryptococcal antigen. Postoperative evaluation revealed pulmonary sarcoidosis. CONCLUSION Central nervous system cryptococcoma is a rare infection that may present in a patient with no known history of immunosuppression and no clinical signs of infection. Diagnostically, this can be difficult to distinguish from a brain tumor. Central nervous system cryptococcoma is an opportunistic infection that typically occurs in the presence of an immunosuppressed state. Sarcoidosis should be considered a predisposing factor because patients with this underlying disease have an increased susceptibility to this central nervous system fungal infection.

scholarly journals Fatal bromethalin intoxication in 3 cats and 2 dogs with minimal or no histologic central nervous system spongiform change

2018 ◽  
Vol 30 (4) ◽  
pp. 642-645 ◽  
Author(s):  
Megan C. Romano ◽  
Alan T. Loynachan ◽  
Dave C. Bolin ◽  
Uneeda K. Bryant ◽  
Laura Kennedy ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
White Matter ◽  
Clinical Signs ◽  
Experimental Models ◽  
Presumptive Diagnosis ◽  
Spongiform Change ◽  
History Of ◽  
The Central Nervous System ◽  
Cns Lesions

Use of the neurotoxic rodenticide bromethalin has steadily increased since 2011, resulting in an increased incidence of bromethalin intoxications in pets. Presumptive diagnosis of bromethalin toxicosis relies on history of possible rodenticide exposure coupled with compatible neurologic signs or sudden death, and postmortem examination findings that eliminate other causes of death. Diagnosis is confirmed by detecting the metabolite desmethylbromethalin (DMB) in tissues. In experimental models, spongiform change in white matter of the central nervous system (CNS) is the hallmark histologic feature of bromethalin poisoning. We describe fatal bromethalin intoxication in 3 cats and 2 dogs with equivocal or no CNS white matter spongiform change, illustrating that the lesions described in models can be absent in clinical cases of bromethalin intoxication. Cases with history and clinical signs compatible with bromethalin intoxication warrant tissue analysis for DMB even when CNS lesions are not evident.

Baylisascaris procyonis Central Nervous System Infection in a Four-Month-Old Gordon Setter Dog

2019 ◽  
Vol 55 (3) ◽  
Author(s):  
Heidi Barnes Heller ◽  
Susan Arnold ◽  
Jennifer L. Dreyfus
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cross Sections ◽  
Complete Blood Count ◽  
Central Nervous System Infection ◽  
Clinical Signs ◽  
Baylisascaris Procyonis ◽  
Trial Treatment ◽  
History Of ◽  
Size And Morphology

ABSTRACT A 16 wk old intact female Gordon setter was examined for a 2 wk history of progressive cerebellovestibular ataxia. Eosinophilia was found on complete blood count, and the remaining blood work was normal. A trial treatment with clindamycin and anti-inflammatory prednisone did not result in improvement of clinical signs; therefore, the dog was euthanized. On histopathologic examination, cross sections of a 75 μm wide nematode larva with a 5 μm cuticle, prominent lateral cords, lateral alae, and coeloemyelian musculature were identified in a focally extensive region of cerebellar necrosis. The size and morphology of the parasites was most consistent with Baylisascaris procyonis. This case highlights a rare but important zoonotic disease that should be considered as a differential diagnosis in any dog exhibiting acute, progressive central nervous system signs, and peripheral eosinophilia. The index of suspicion should be elevated in dogs with an unknown deworming history and known or suspected exposure to raccoons. Because most anthelminthics have been shown to be effective against B. procyonis, annual deworming is recommended in the at-risk population to reduce the likelihood of aberrant migration and zoonosis.

scholarly journals Acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) associated with choroidal melanoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aluisio Rosa Gameiro Filho ◽  
Guilherme Sturzeneker ◽  
Ever Ernesto Caso Rodriguez ◽  
André Maia ◽  
Melina Correia Morales ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Serous Retinal Detachment ◽  
Central Nervous System Involvement ◽  
Choroidal Melanoma ◽  
Posterior Pole ◽  
Pancreatic Metastasis ◽  
Small Areas ◽  
History Of ◽  
The Right

Abstract Background To report a case of acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with a history of choroidal melanoma, with metastases to the pancreas, liver, and central nervous system. Case presentation A 63-year-old patient, with a history of enucleation of the right eye due to choroidal melanoma, complained of progressive visual loss during a follow-up visit. Fundoscopic examination revealed multiple small areas of serous retinal detachment scattered throughout the posterior pole and ancillary tests confirmed the diagnosis of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM). Screening for systemic metastases showed pancreatic, hepatic, and central nervous system involvement. Conclusions We describe a rare case of acute exudative polymorphous paraneoplastic vitelliform maculopathy, which should be considered in patients with or without a history of melanoma, who have vitelliform retinal detachments. Nevertheless, no previous reviews of literature have shown a correlation between AEPPVM and pancreatic metastasis.

scholarly journals Diagnosis, treatment, and misdiagnosis analysis of 28 cases of central nervous system echinococcosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Guojia Du ◽  
Yandong Li ◽  
Pan Wu ◽  
Xin Wang ◽  
Riqing Su ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Clinical Features ◽  
Multiple Organ ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Surgical Treatments

Abstract Background To explore central nervous system (CNS) involvement in this disease, from the perspectives of diagnosis, treatment, and misdiagnosis Methods Twenty-eight patients with CNS echinococcosis were included in this retrospective study, including 18 males (64.3%) and 10 (35.7%) females. The average age of all the patients were 23.5 years (ranged 4–60 years). Twenty-three (23) patients (82.1%) received the first surgical resection in our hospital. Five (5) patients (17.9%) gave up surgical treatment for multiple-organ hydatidosis and previous surgery history at other hospitals, and albendazole was applied for a long-term (3–6 months) adjunct therapy for the 5 patients. The average follow-up time was 8 years. Results For the 28 patients, 23 cases received surgical treatments, and the diagnosis was confirmed by pathological examinations. The diagnosis of 4 cases of brain echinococcosis and 2 cases of spinal cord echinococcosis could not be confirmed, resulting in a misdiagnosis rate of 21.4% (6/28). For the pathological examination, a total of 17 cases were infected with Echinococcus granulosus (including 2 cases of spinal cord echinococcosis), and 6 cases were infected with Echinococcus alveolaris. Conclusion The diagnosis should be specifically considered in endemic regions. The clinical features of CNS hydatidosis were intracranial space-occupying lesions. For the treatment, the surgical removal of cysts should be necessary. In addition, the adjuvant therapy with drug and intraoperative prophylaxis is also suggested. The misdiagnosis may have resulted from atypical clinical features and radiographic manifestations, as well as the accuracy of hydatid immunologic test.

scholarly journals Natural history of central nervous system acute leukemia in adults

Cancer ◽  
1981 ◽  
Vol 47 (1) ◽  
pp. 184-196 ◽  
Author(s):  
David J. Stewart ◽  
Michael J. Keating ◽  
Kenneth B. McCredie ◽  
Terry L. Smith ◽  
Eshan Youness ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Natural History ◽  
Acute Leukemia ◽  
History Of

EPID-24. TRANSCRIPT: A cenTRAl NERVOUS SYSTEM CANCER CLINICAL tRIals PostmorTem

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi91-vi91
Author(s):  
Yeonju Kim ◽  
Terri Armstrong ◽  
Mark Gilbert ◽  
Orieta Celiku
Keyword(s):  
Central Nervous System ◽  
Overall Survival ◽  
Clinical Trials ◽  
Nervous System ◽  
Brain Tumor ◽  
Objective Response ◽  
Survival Rates ◽  
Maximum Tolerated Dose ◽  
Secondary Outcome ◽  
Patient Reported

Abstract BACKGROUND Despite the growing number of neuro-oncology clinical trials, there have been limited advances in the treatment of malignant primary central nervous system tumors. We surveyed the landscape of past, ongoing, and planned trials to assess trends in their interventions, outcomes, and design considerations to guide future studies. METHODS Data on interventional trials on ClinicalTrials.gov were accessed programmatically using AACT and R. Neuro-oncology trials were isolated using primary malignant brain tumor classification terms. Instrument names from PROQOLID were used to identify clinical outcome assessment (COA) use. Linear regression was used to assess chronological trends; power analyses utilized CBTRUS survival rates among trials investigating overall survival. RESULTS We identified 3039 interventional brain tumor trials that started between 1966 and 2025. Trials were most frequently phase II (43%), completed (40%), non-blinded (92%), single-group assignment (65%), non-randomized (51%) studies targeting glioblastoma (45%). Planned outcomes were reported by 93% of trials; this included adverse event or toxicity (54%), overall/x-year survival (44%), progression free survival (43%), maximum tolerated dose (16%), and objective response rate (14%). Evaluating the anticipated and actual trial enrollment, we estimate that only 10% and 8% of trial arms, respectively, were sufficiently powered to assess overall survival endpoints. 21% of trials mentioned the use of a COA (first trial initiated in 1992), majority of which were patient-reported outcomes. Among these, 25% and 58% reported COA as a primary or secondary outcome, respectively. The rate of COA use increased linearly over time at 1.1%/year but remained less than 5 trials per year until 2003. Ongoing work is investigating treatment mechanisms of actions and evidence of preclinical efficacy among brain tumor studies. CONCLUSIONS Low randomization rates and underpowered trial design may impede interpretability of efficacy. Increasing trends in COA use suggests cumulative influence of advocacy efforts to holistically evaluate net clinical benefit of interventions.

THE FAMILY HISTORY OF SPINA BIFIDA CYSTICA

PEDIATRICS ◽  
1965 ◽  
Vol 35 (4) ◽  
pp. 589-595
Author(s):  
John Lorber
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Spina Bifida ◽  
Index Case ◽  
Progressive Increase ◽  
Point Of View ◽  
The Family ◽  
History Of ◽  
The Central Nervous System ◽  
Spina Bifida Cystica

1. The family histories of 722 infants who were born with spina bifida cystica were studied. 2. The index cases were referred for surgical treatment and were not selected in any way from the genetic point of view. 3. Intensive inquiries were made to obtain a complete family pedigree, including a prospective follow-up of siblings born after the index case. 4. Of 1,256 siblings 85 or 6.8% had gross malformation of the central nervous system: spina bifida cystica in 54, anencephaly in 22, and uncomplicated hydrocephalus in 9. 5. Of 306 children born after the index case 25 (8%) or 1 in 12 were affected. 6. There was a progressive increase in multiple cases in the family with increasing family size. In sibships of five or more, multiple cases occurred in 24.1%. 7. In 118 families cases of gross malformation of the central nervous system were known to have occurred among members of the family other than siblings. Cases occurred in three generations. 8. It is possible that spina bifida cystica might be a recessively inherited condition.

scholarly journals The life history of Hepatozoon leptodactyli (Lesage, 1908) Pessoa, 1970: a parasite of the common laboratory animal: the frog of the genus Leptodactylus

1973 ◽  
Vol 71 (1-2) ◽  
pp. 1-8 ◽  
Author(s):  
Sylvio Celso Goncalves da Costa ◽  
Samuel B. Pessoa ◽  
Neize de Moura Pereira ◽  
Tania Colombo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Life History ◽  
Laboratory Animal ◽  
Peripheral Circulation ◽  
Experimental Conditions ◽  
History Of ◽  
The Central Nervous System ◽  
The Common ◽  
Common Laboratory

The main object of the present paper is to furnish a brief account to the knowledgement of Protozoa parasitic in common Brazilian frog of the genus Leptodactylus for general students in Zoology and for investigators that use this frog as a laboratory animal. Hepatozoon leptodactyli (Haemogregarina leptodactyli) was found in two species of frogs - Leptodactylus ocellatus and L. pentadactylus - in which develop schizogony whereas sporogony occurs in the leech Haementeria lutzi as was obtainded in experimental conditions. Intracellular forms have been found in peripheral circulation, chiefly in erythrocytes, but we have found them in leukocytes too. Tissue stages were found in frog, liver, lungs, spleen, gut, brain and heart. The occurence of hemogregarine in the Central Nervous System was recorded by Costa & al,(13) and Ball (2). Some cytochemical methods were employed in attempt to differentiate gametocytes from trophozoites in the peripheral blood and to characterize the cystic membrane as well. The speorogonic cycle was developed in only one specie of leech. A brief description of the parasite is given.

scholarly journals Uji Toksisitas Akut Ekstrak Etanol Daun Sapu Jagad (Isotoma longiflora (L) Presl.) pada Mencit Galur Mus muculus

2017 ◽  
Vol 4 (1) ◽  
pp. 42
Author(s):  
Ira Safitri ◽  
Inayah Inayah
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Herbal Medicine ◽  
Acute Toxicity ◽  
Lethal Dose ◽  
Clinical Signs ◽  
Probit Analysis ◽  
Acute Toxicity Test ◽  
Pharmacological Effects ◽  
Per Oral

Sapu Jagad (Isotoma longiflora (L) Presl.) plant has been empirically used as traditional medicine. Some studies showthat this plant has pharmacological effects as antibiotic, anticancer, and analgetic. It is of importance to conduct studyin finding out the safetiness of this plant as herbal medicine. Therefore, we conducted study to find out lethal dose ofits leaves on mice (Mus muculus) using acute toxicity test. Several doses have been given to certain groups to find outits effect including death. The extract has been given one time per oral. Then, we recorded the clinical signs and deathof mice until 14 days. The data was analyzed using probit analysis to measure LD50. This study shows that ethanolextract of Sapu Jagad leaves has LD50 12.610 mg/kgBW and toxicity of central nervous system proven by seizureending with death. As conclusion, this extract has toxicity especially to central nervous system.

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