Non-inflammation cerebrospinal fluid and normal brain magnetic resonance images of Autoimmune encephalits

2019 ◽  
Author(s):  
Yake Zheng ◽  
Peng Zhao ◽  
yajun lian ◽  
Lihao Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Brain Mri ◽  
Clinical Manifestations ◽  
Speech Disorders ◽  
Magnetic Resonance Images ◽  
Normal Brain ◽  
Recurrence Rates ◽  
Clinical Prognosis

Abstract Background We set out to investigate the characteristics and factors related to non-inflammation cerebrospinal fluid (CSF) and normal brain magnetic resonance images (MRI) of autoimmune encephalitis (AE) in patients. Methods The distribution and characteristics of brain MRI and CSF in 124 patients who were living with anti-NMDAR(71), LGI1(26),CASPR2(4),GABAR(23) encephalitis and who had been admitted between October 2016 and May 2018 were analyzed prospectively. Results 12 of the 124 patients(1%) had a normal MRI and non-inflammation CSF.Ten of them were LGI1(83%),while the remaining 1 patient was NMDAR(8.3%),1 patient was CASPR2(8.3%).The clinical symptoms including epilepsy, psychosis, cognitive disorders, conscious disorders, headache, faciobrachial dystonic seizure (FBDS), speech disorders and hypoventilation. AE with non-inflammation CSF and normal MRI with good clinical prognosis. The median modified Rankin Scale (mRS) was low, and recurrence rate was also low. Conclusion The clinical manifestations of on-inflammation CSF and brain MRI-negative patients with AE are not specific, but suggest a better prognosis and a lower recurrence rates.

Magnetic resonance imaging findings and its association to electroencephalogram in children with partial epilepsy (Preprint)

2020 ◽  
Author(s):  
Huynh Quang Huy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Preschool Children ◽  
Magnetic Resonance ◽  
Brain Mri ◽  
Partial Epilepsy ◽  
Small Sample ◽  
Normal Brain ◽  
Resonance Imaging ◽  
Normal Children ◽  
Eeg Abnormalities

BACKGROUND It is important to identify the neuroimaging features that are associated with partial epilepsy in preschool children. Advances in technology recently to localize focal epileptogenic lesions, especially that of high-resolution structural imaging with magnetic resonance imaging (MRI). The recommendation that electroencephalography (EEG) should be gold criteria and that M.R.I should be optional has been questioned. OBJECTIVE The present study aims to to explore the brain lesions on MRI and its association to electroencephalogram in children with partial epilepsy. METHODS The present study was conducted among 112 preschool children with history of partial seizures. All patients underwent EEG and brain MRI. The epileptogenic lesions were identified on the basis of the signal intensities and morphological abnormalities seen on MRI. The correlation between MRI and EEG abnormalities was explored using a chi-square test. RESULTS Abnormal MRI were found in 34.8% (n = 39) of the sample. The EEG and MRI agreed with respect to classify into abnormal or normal in 48.2% (n = 54). Of the 27 patients with a normal EEG, six (22.2%) were seen to have an abnormal MRI. CONCLUSIONS A number of MRI abnormalities was found in our study of otherwise normal children, although the correlation between these results was not clear. Follow-up of these children will help us identify the important abnormalities. Despite of small sample, our results showed that a normal E.E.G findings does not predict a normal brain MRI in children with partial epilepsy.

scholarly journals Neurobrucellosis mimicking primary vasculitis of the central nervous system: we should perform a metagenomic analysis of the cerebrospinal fluid prior to brain biopsy

2021 ◽  
Author(s):  
Marina Barrionuevo Mathias ◽  
Fernando Gatti ◽  
Gustavo Bruniera ◽  
Vitor Paes ◽  
Gisele Sampaio Silva ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Psychiatric Symptoms ◽  
Brain Mri ◽  
Genetic Material ◽  
Clinical Manifestations ◽  
Brain Biopsy ◽  
Metagenomic Analysis ◽  
Normal Brain ◽  
The Central Nervous System

Context Primary angiitis of the central nervous system (PACNS) is characterized by the inflammation of small and medium CNS arteries; the clinical manifestations include headache, cognitive impairment and focal neurological deficits. The gold standard test for diagnosis is brain biopsy. Neurobrucellosis is an infection associated with cattle farming, which leads to neurological and psychiatric symptoms. We report a case of neurobrucellosis mimicking PACNS. Case report Male, 32 years old, with fever, headache, dizziness and cognitive impairments for 30 days. History of stroke 2 years before, with mild sequelae right hemiparesis; investigation showed suspected intracranial dissection. On physical examination, he had apathy, preserved strength, reduced reflexes with plantar flexor responses. General laboratory tests, autoantibodies and serology were normal. Brain MRI showed deep left nucleocapsular gliosis and cerebral angiography revealed stenosis of the ICA and MCA. CSF showed 42 cells/ mm³, glucose 46 mg/dL, protein 82 mg/dL. Blood PCR was negative for Brucella. Immunophenotyping of the CSF and PET-CT excluded neoplasia. Brain biopsy was inconclusive for vasculitis. Metagenomic analysis of the CSF detected 78% of Brucella genetic material. Serum agglutination test was 1:40 for brucella. Conclusions PACNS is diagnosed by exclusion. The patient filled criteria for possible PACNS, image compatible with vascular stenosis, but inconclusive brain biopsy. Brucellosis is an endemic disease in underdeveloped countries that can present as CNS vasculitis. Metagenomic analysis allows the detection of different pathogens using a single method. The case illustrates the use of metagenomics in rare diseases characterized by vasculitis, with change in clinical outcomes and conduct.

scholarly journals An Uncommon Case of Pediatric Neurobrucellosis Associated with Intracranial Hypertension

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Xenophon Sinopidis ◽  
Joseph Kaleyias ◽  
Konstantina Mitropoulou ◽  
Maria Triga ◽  
Sanjeev V. Kothare ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Brucella Melitensis ◽  
Brain Mri ◽  
Accurate Diagnosis ◽  
Normal Brain ◽  
Pcr Assay ◽  
Cerebrospinal Fluid Culture ◽  
Uncommon Case ◽  
Fluid Culture

We present the case of a 4-year-old boy who was admitted to hospital with intracranial hypertension, headache, diplopia, papilledema, and a normal brain MRI.Brucella melitensisin the cerebrospinal fluid was confirmed with PCR assay. We believe that neurobrucellosis should be included in the differential diagnosis when headaches persist following brucellosis. In addition, we suggest that when cerebrospinal fluid culture is negative, PCR may prove to be an optimal alternative tool for an immediate and accurate diagnosis.

Atypical Localization of Enchondroma in the Calcaneus

2015 ◽  
Vol 105 (3) ◽  
pp. 260-263 ◽  
Author(s):  
Erkam Komurcu ◽  
Burak Kaymaz ◽  
Umut Hatay Golge ◽  
Ferdi Goksel ◽  
Mustafa Resorlu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Physical Examination ◽  
Clinical Manifestations ◽  
Magnetic Resonance Images ◽  
Heel Pain ◽  
Definitive Treatment ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
The Right ◽  
Atypical Localization

A 53-year-old man presented to the orthopedic outpatient clinic with pain and swelling in the right heel without any trauma. On physical examination and radiologic assessment, a lesion with calcification and peripheral sclerosis was detected in the medullary cavity of the calcaneus, and computed tomographic images revealed cortical thinning adjacent to the lesion. Magnetic resonance images showed a 23 × 19-mm lesion. Tru-Cut biopsy, performed to clarify the diagnosis, revealed an enchondroma. As a definitive treatment, curettage of the lesion and grafting of the cavity was performed. Although enchondromas are common pathologic abnormalities of the skeleton and are usually asymptomatic, atypical localization, such as the calcaneus, and atypical clinical manifestations, such as heel pain, should also be kept in mind.

Thoracic mobile neurinoma

1993 ◽  
Vol 79 (2) ◽  
pp. 277-279 ◽  
Author(s):  
Shobu Namura ◽  
Junya Hanakita ◽  
Hideyuki Suwa ◽  
Masaki Mizuno ◽  
Toshiyuki Ohtsuka ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Rare Case ◽  
Clinical Symptoms ◽  
Tumor Location ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Fine Print

✓ The authors report a rare case of intraspinal thoracic mobile neurinoma in a 51-year-old man. The clinical symptoms, especially thoracoabdominal discomfort, changed remarkably according to the patient's posture. Magnetic resonance images demonstrated that the level of the caudal end of the tumor varied between T4–5 and T9–10 with changes in the patient's position. Intraoperative myelography was useful in identifying the tumor location and choosing the level of the laminectomy.

Endoscopic Fenestration of A Symptomatic Cavum Septum Pellucidum:Technical Case Report

2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-E491-ONS-E491 ◽  
Author(s):  
Astrid Weyerbrock ◽  
Todd Mainprize ◽  
James T. Rutka
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Pathological Condition ◽  
Obstructive Hydrocephalus ◽  
Invasive Technique ◽  
Resonance Imaging ◽  
Cerebrospinal Fluid Flow ◽  
Endoscopic Fenestration

Abstract OBJECTIVE: Cysts of the septum pellucidum (CSPs) may become symptomatic because of obstruction of cerebrospinal fluid flow, resulting in increased intracranial pressure and hydrocephalus requiring surgical intervention. Endoscopic fenestration may be the most effective and least invasive technique to treat this pathological condition. CLINICAL PRESENTATION: An 11-year-old boy sought treatment for frequent episodes of severe headache. On examination, he had papilledema. There was evidence on magnetic resonance imaging scans of a space-occupying CSP with obstructive hydrocephalus. INTERVENTION: The endoscopic technique of fenestration of both lateral walls of an enlarged CSP via a left frontal approach under ultrasound guidance using a rigid endoscope was successful. After surgery, the patient became asymptomatic, his papilledema resolved, and magnetic resonance imaging scans demonstrated collapse of the walls of the CSP toward the midline. CONCLUSION: Neuroendoscopic fenestration should be strongly considered as the treatment of choice for symptomatic CSPs. This procedure alone can lead to complete resolution of clinical symptoms and hydrocephalus, can reduce the size of the CSP, and can obviate the need for an implantable cerebrospinal fluid shunt.

scholarly journals Unusual primary sphenoid adenoid cystic carcinoma: the importance of combined CT and MR evaluation

2016 ◽  
Vol 15 (2) ◽  
pp. 297-302
Author(s):  
Mohd Syafwan Mohd Soffian ◽  
Rohaizam Jaafar ◽  
Norhafiza Mat Lazim ◽  
Norliana Dalila Mohamad Ali
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Adenoid Cystic Carcinoma ◽  
Clinical Symptoms ◽  
Medical Science ◽  
Magnetic Resonance Images ◽  
Intracranial Extension ◽  
Diagnostic Challenge ◽  
Adenoid Cystic ◽  
Abducent Nerve Palsy

Objective: To report a diagnostic challenge of primary sphenoid adenoid cystic carcinoma. Case summary: A 60-year-old premorbid healthy lady presented with progressive deterioration of visual acuity of the left eye associated with diplopia, left epiphora and left ear blockage for two weeks duration. Examination revealed a ‘non perception of light’ (NPL) of the left eye with left abducent nerve palsy. The nasoendoscopic findings were unremarkable. Initial computed tomography of the brain and paranasal sinus showed a large clivus tumor with intracranial extension while subsequent magnetic resonance detected the epicenter of the tumour appeared to be in the sphenoid sinus with extension to the surrounding structures. A transeptal transsphenoidal biopsy was done reported as mixed pattern adenoid cystic adenocarcinoma. Discussion: Primary sphenoid adenoid cystic carcinoma is an extremely rare slow growing malignancy with non-specific clinical symptoms. The neuro-ophthalmology symptoms are the main presentation. Combined computed tomography and magnetic resonance images are essential in establishing differential diagnosis and to delineate the extent of this disease. Combined modality of surgery and postoperative radiation for adenoid cystic carcinoma has proven better results. Conclusions: Primary sphenoid adenoid cystic carcinoma poses a diagnostic challenge clinically. Combined radiological characteristic from computed tomography and magnetic resonance images are essential to aid the diagnosis.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.297-302

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