Radiographic Improvement of Larval Cysts in Neurocysticercosis

2020 ◽  
Author(s):  
David R. Landzberg ◽  
Anuj Dhir ◽  
Dinesh V. Jillella
Keyword(s):  
Radiographic Improvement

scholarly journals Medical Adjuvants in the Treatment of Surgically Refractory Arteriovenous Malformations of the Head and Face: Case Report and Review of Literature

2021 ◽  
pp. 1-7
Author(s):  
Vaidya Govindarajan ◽  
Joshua D. Burks ◽  
Evan M. Luther ◽  
John W. Thompson ◽  
Robert M. Starke
Keyword(s):  
Arteriovenous Malformations ◽  
Mtor Inhibitors ◽  
Molecular Target ◽  
Review Of Literature ◽  
Review Of The Literature ◽  
Early Results ◽  
Number Of Patients ◽  
Initiation Of Therapy ◽  
The Brain ◽  
Radiographic Improvement

<b><i>Background:</i></b> Arteriovenous malformations (AVMs) of the brain and face present unique challenges for clinicians. Cerebral AVMs may induce hemorrhage or form aneurysms, while facial AVMs can cause significant disfigurement and pain. Moreover, facial AVMs often draw blood supply from arteries providing critical blood flow to other important structures of the head which may make them impossible to treat curatively. Medical adjuvants may be an important consideration in the management of these patients. <b><i>Summary:</i></b> We conducted a systematic review of the literature to identify other instances of molecular target of rapamycin (mTOR) inhibitors used as medical adjuvants for the treatment of cranial and facial AVMs. We also present 2 cases from our own institution where patients were treated with partial embolization, followed by adjuvant therapy with rapamycin. After screening a total of 75 articles, 7 were identified which described use of rapamycin in the treatment of inoperable cranial or facial AVM. In total, 21 cases were reviewed. The median treatment duration was 12 months (3–24.5 months), and the highest recorded dose was 3.5 mg/m<sup>2</sup>. 76.2% of patients demonstrated at least a partial response to rapamycin therapy. In 2 patients treated at our institution, symptomatic and radiographic improvement were noted 6 months after initiation of therapy. <b><i>Key Messages:</i></b> Early results have been encouraging in a small number of patients with inoperable AVM of the head and face treated with mTOR inhibitors. Further study of medical adjuvants such as rapamycin may be worthwhile.

scholarly journals Ifosfamide May Be Safely Used in Patients with End Stage Renal Disease on Hemodialysis

Sarcoma ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Sheron Latcha ◽  
Robert G. Maki ◽  
Gary K. Schwartz ◽  
Carlos D. Flombaum
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Response To Therapy ◽  
Common Side Effect ◽  
Pharmacokinetic Data ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage ◽  
Metastatic Sarcoma ◽  
Radiographic Improvement

Background. Pharmacokinetic data on clearance of ifosfamide in hemodialysis patients are limited. Consequently, these patients are excluded from therapy with this agent. We review the outcomes for patients at our institution with end stage renal disease on dialysis who received ifosfamide for metastatic sarcoma.Patients and Methods. We treated three patients with end stage renal disease on hemodialysis with escalating doses of ifosfamide. Data on radiographic response to therapy, WBC and platelet counts, signs or symptoms of infection, neuropathy and bladder toxicity are reported. Starting doses of ifosfamide were based on review of the literature available with subsequent modifications based on each patient's prior exposure to myelosuppressive agents and on symptoms of neurotoxicity and the degree of myelosuppression following each cycle of chemotherapy.Results. Myelosuppression was the most common side effect from therapy, but no patient developed a life threatening infection, neurotoxicity, or hematuria. One patient developed epistaxis in the setting of thrombocytopenia while on warfarin therapy. All patients had clinical evidence for therapeutic response and two had documented radiographic improvement following ifosfamide administration.Conclusion. Ifosfamide can be used safely in combination with hemodialysis in patients with end stage renal disease.

scholarly journals Rheumatoid Meningitis: Clinical Characteristics, Diagnostic Evaluation, and Treatment

2019 ◽  
Vol 10 (2) ◽  
pp. 88-94
Author(s):  
Angela M. Parsons ◽  
Fawad Aslam ◽  
Marie F. Grill ◽  
Allen J. Aksamit ◽  
Brent P. Goodman
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Corticosteroid Treatment ◽  
Symptomatic Improvement ◽  
Exclusion Criteria ◽  
Clinical Presentations ◽  
Biopsy Confirmation ◽  
Rheumatoid Meningitis ◽  
Citrullinated Peptide ◽  
Radiographic Improvement

Background and Purpose: Due to the potential for high mortality and neurologic complications of rheumatoid meningitis (RM), awaiting biopsy confirmation may delay vital treatment intervention. Our aim was to describe the clinical presentations of RM in our population and determine whether meningeal biopsy impacted diagnosis, treatment, and outcomes. Methods: A retrospective chart review was completed for patients at Mayo Clinic with a diagnosis of RM within the last 28 years. Those with identified alternative inflammatory, infectious, or neoplastic causes of pachymeningitis or leptomeningitis were excluded. Results: Fourteen patients meeting inclusion/exclusion criteria were identified. All patients were positive for rheumatoid factor or cyclic citrullinated peptide. All patients had magnetic resonance imaging abnormalities characterized by pachymeningeal and/or leptomeningeal enhancement. Of the 10 patients who underwent biopsy, nonspecific findings were seen in 74%. All patients except one were treated with corticosteroids with subsequent symptomatic improvement. Radiographic improvement or resolution was seen in 10 (83%) of 12. Patients improved with corticosteroid treatment, including those who were diagnosed with RM on clinical basis without undergoing a biopsy as well. Conclusions: This retrospective review displays the myriad of clinical presentations of RM. It also suggests that with appropriate exclusion of infectious, neoplastic, and other autoimmune etiologies, biopsy may not be necessary to initiate treatment.

scholarly journals Modified Dunn Procedure is Superior to In Situ Pinning for Short-term Clinical and Radiographic Improvement in Severe Stable SCFE

2014 ◽  
Vol 473 (6) ◽  
pp. 2108-2117 ◽  
Author(s):  
Eduardo N. Novais ◽  
Mary K. Hill ◽  
Patrick M. Carry ◽  
Travis C. Heare ◽  
Ernest L. Sink
Keyword(s):  
Short Term ◽  
In Situ Pinning ◽  
Radiographic Improvement

scholarly journals Daratumumab (Anti-CD38) for Treatment of Disseminated Nontuberculous Mycobacteria in a Patient With Anti–Interferon-γ Autoantibodies

2020 ◽  
Author(s):  
Sebastian Ochoa ◽  
Li Ding ◽  
Samantha Kreuzburg ◽  
Jennifer Treat ◽  
Steven M Holland ◽  
...  
Keyword(s):  
Nontuberculous Mycobacteria ◽  
Interferon Γ ◽  
The Novel ◽  
Mycobacterial Infections ◽  
Ifn Γ ◽  
Radiographic Improvement

Abstract Patients with autoantibodies to interferon-γ (IFN-γ) may develop severe nontuberculous mycobacterial infections. We describe the novel use of daratumumab in a patient with autoantibodies to IFN-γ who had progressive infection, resulting in clinical and radiographic improvement.

scholarly journals PATH-60. PRIMARY CNS LYMPHOMA PRECEDED BY ACUTE DEMYELINATION

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi156-vi157
Author(s):  
Justin Low ◽  
Anne Buckley ◽  
Dina Randazzo
Keyword(s):  
Oral Prednisone ◽  
Primary Cns Lymphoma ◽  
Brain Biopsy ◽  
B Cell Lymphoma ◽  
High Grade Glioma ◽  
Acute Disseminated Encephalomyelitis ◽  
Cns Lymphoma ◽  
Central Demyelination ◽  
Initial Biopsy ◽  
Radiographic Improvement

Abstract Primary CNS lymphoma commonly presents with nonspecific encephalopathy or focal neurologic deficits. Magnetic resonance imaging typically shows a homogeneously enhancing mass with surrounding edema. The imaging differential diagnosis is broad, and includes high grade glioma and neuroinflammatory conditions. Definitive diagnosis therefore requires biopsy. Here we present a case of primary CNS lymphoma that was diagnosed as an acute demyelinating process on initial biopsy. A 68 year old female presented with gait instability and vertigo. MRI showed right cerebellar and right trigonal enhancing lesions. Biopsy revealed an acute demyelinating inflammatory process and she was diagnosed with acute disseminated encephalomyelitis. She was treated with intravenous methylprednisolone followed by oral prednisone with resulting clinical and radiographic improvement. She was re-admitted to hospital 4 months later with encephalopathy. Imaging showed a new enhancing mass in the pericallosal frontal lobes. Repeat brain biopsy showed diffuse large B-cell lymphoma. This case illustrates a highly unusual situation of biopsy-proven central demyelination preceding a primary CNS lymphoma diagnosis. It raises a number of etiopathological questions concerning the coexistence and potential causal relationships between demyelination and lymphoma. Additionally, it highlights the need for repeat biopsy if clinical and radiographic suspicion for lymphoma persists despite an alternative initial biopsy result.

scholarly journals Manipulation of Displaced Distal Radial Fractures in the Superelderly: Prediction of Malunion and the Degree of Radiographic Improvement

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
N. D. Clement ◽  
A. D. Duckworth ◽  
C. M. Court-Brown ◽  
M. M. McQueen
Keyword(s):  
Surgical Intervention ◽  
Independent Predictor ◽  
Ulnar Variance ◽  
Distal Radial Fractures ◽  
Significant Independent Predictor ◽  
Fracture Position ◽  
Increased Risk ◽  
Dorsal Angulation ◽  
Radiographic Improvement ◽  
Prospective Database

Superelderly patients (≥80 years old) account for 20% of all distal radial fractures and are at an increased risk of malunion. The primary aim of this study was to identify predictors of malunion and the degree of improvement in the fracture position offered by closed manipulation of displaced distal radial fractures in the superelderly. We retrospectively identified 228 displaced distal radial fractures in superelderly patients from a prospective database of 4024 distal radial fractures. The inclusion criterion was a patient that underwent closed manipulation as their primary intervention. The majority of patients (n=196, 86%) were defined as having a malunion. A premanipulation dorsal angulation of greater than 25 degrees (P=0.047) and an ulnar variance of 6 mm or more (P=0.02) significantly increased the risk of malunion. The premanipulation dorsal angulation was a significant independent predictor of the degree of improvement in the final dorsal angulation (P<0.001) and ulnar variance (P=0.01). Patients with a high risk of malunion or poor improvement in the fracture position can be identified before manipulation and these patients may benefit from primary surgical intervention.

scholarly journals Epidural Lipomatosis and Associated Spinal Stenosis—The Impact of Weight Loss: A Case Report

2017 ◽  
Vol 11 (6) ◽  
pp. 511-514 ◽  
Author(s):  
William J. Beckworth ◽  
Erin J. McCarty ◽  
Jose E. Garcia-Corrada ◽  
John F. Holbrook
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Ligamentum Flavum ◽  
Radiographic Finding ◽  
Lumbar Stenosis ◽  
Obesity Epidemic ◽  
Epidural Lipomatosis ◽  
Dietary Weight Loss ◽  
The Impact ◽  
Radiographic Improvement

Lumbar stenosis is a common radiographic finding that sometimes can be symptomatic. It usually results from a degenerative process of hypertrophic facets, ligamentum flavum hypertrophy, and disc involvement. A prominence of fat in the epidural space, epidural lipomatosis, can also be a contributing factor. This case report presents a 55-year-old man with radiographic improvement of epidural lipomatosis and stenosis from dietary weight loss. Given the rising obesity epidemic, practitioners should be cognizant of epidural lipomatosis and consider weight loss as a possible treatment option.

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