scholarly journals A Frontal Lobe Meningioma in a Child Leading to Visual Loss

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Nedime Sahinoglu-Keşkek ◽  
Gokhan Soker ◽  
Şakir Özgür Keşkek ◽  
Sehire Sahinoglu ◽  
Figen Unal ◽  
...  
Keyword(s):  
Visual Loss ◽  
Clinical Presentation ◽  
Low Vision ◽  
Optic Chiasm ◽  
Intracranial Tumor ◽  
Intracranial Meningioma ◽  
Resonance Imaging ◽  
Blurred Vision ◽  
History Of ◽  
Meningeal Tumors

Objective. Meningiomas are benign primary meningeal tumors and are seen rare in children and adolescents.Clinical Presentation and Intervention. A 15-year-old Turkish boy reported a 1-month history of headache and blurred vision in both eyes. His visual acuity was 0.3 in both eyes with papilledema. Magnetic resonance imaging showed a77×97×77 mm intracranial-extra-axial frontal lesion which compresses the chiasm. He was diagnosed with intracranial meningioma and referred to neurosurgery clinic.Conclusion. Ophthalmologists should be aware of the fact that papilledema and low vision can be caused by an intracranial tumor which compresses optic chiasm.

scholarly journals A woman with visual loss, amenorrhoea and polyuria: the first reported case of nodular lymphocyte-predominant Hodgkin lymphoma presenting with hypopituitarism

2021 ◽  
Vol 2021 ◽  
Author(s):  
Matthew Seymour ◽  
Thomas Robertson ◽  
Jason Papacostas ◽  
Kirk Morris ◽  
Jennifer Gillespie ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Visual Loss ◽  
Post Partum ◽  
Bone Lesion ◽  
Optic Chiasm ◽  
High Dose ◽  
List Type ◽  
Sellar Mass ◽  
Blurred Vision ◽  
Surgical Biopsy

Summary A 34-year-old woman presented 18 months post-partum with blurred vision, polyuria, amenorrhoea, headache and general malaise. Comprehensive clinical examination showed left superior temporal visual loss only. Initial investigations revealed panhypopituitarism and MRI demonstrated a sellar mass involving the infundibulum and hypothalamus. Lymphocytic hypophysitis was suspected and high dose glucocorticoids were commenced along with desmopressin and thyroxine. However, her vision rapidly deteriorated. At surgical biopsy, an irresectable grey amorphous mass involving the optic chiasm was identified. Histopathology was initially reported as granulomatous hypophysitis. Despite the ongoing treatment with glucocorticoids, her vision worsened to light detection only. Histopathological review revised the diagnosis to partially treated lymphoma. A PET scan demonstrated avid uptake in the pituitary gland in addition to splenic involvement, lymphadenopathy above and below the diaphragm, and a bone lesion. Excisional node biopsy of an impalpable infraclavicular lymph node confirmed nodular lymphocyte-predominant Hodgkin lymphoma. Hyper-CVAD chemotherapy was commenced, along with rituximab; fluid-balance management during chemotherapy (with its requisite large fluid volumes) was extremely complex given her diabetes insipidus. The patient is now in clinical remission. Panhypopituitarism persists; however, her vision has recovered sufficiently for reading large print and driving. To the best of our knowledge, this is the first reported case of Hodgkin lymphoma presenting initially as hypopituitarism. Learning points Lymphoma involving the pituitary is exceedingly rare and, to the best of our knowledge, this is the first reported case of nodular lymphocyte-predominant Hodgkin lymphoma presenting as hypopituitarism. There are myriad causes of a sellar mass and this case highlights the importance of reconsidering the diagnosis when patients fail to respond as expected to appropriate therapeutic intervention. This case highlights the difficulties associated with managing panhypopituitary patients receiving chemotherapy, particularly when this involves large volumes of i.v. hydration fluid.

scholarly journals Monocular Vision Loss: A Rare Cause

2019 ◽  
Vol 3 (4) ◽  
pp. 436-437
Author(s):  
David Lane ◽  
Kaila Pomeranz ◽  
Shannon Findlay ◽  
Daniel Miller
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Vision Loss ◽  
Metastatic Breast ◽  
Optic Chiasm ◽  
Monocular Vision ◽  
Resonance Imaging ◽  
History Of ◽  
Cerebral Structures ◽  
Optic Nerve Compression

A 62-year-old woman with a history of metastatic breast cancer and known meningioma presented with unilateral vision loss associated with anisocoria and an afferent pupillary defect. On magnetic resonance imaging we found the cause to be optic nerve compression by a right frontal meningioma. Monocular vision-loss etiologies are anatomically localized to structures anterior to the optic chiasm. This case serves as a reminder that cerebral structures in this location must not be forgotten in the differential.

scholarly journals Optochiasmatic tuberculoma as the sole manifestation of late recurrent tuberculosis

2012 ◽  
Vol 54 (4) ◽  
pp. 229-230 ◽  
Author(s):  
Marco A. Lima ◽  
Antonio Aversa ◽  
Pericles Maranhão-Filho ◽  
Gabriela A. Lima ◽  
Andre Curi ◽  
...  
Keyword(s):  
Developing Countries ◽  
Visual Loss ◽  
Brain Mri ◽  
Optic Chiasm ◽  
Brain Lesions ◽  
Past Medical History ◽  
Presumptive Diagnosis ◽  
History Of ◽  
Tuberculosis Diagnosis ◽  
Recurrent Tuberculosis

Brain tuberculomas account for 10-20% of space occupying brain lesions in developing countries. Most lesions are observed at time of tuberculosis diagnosis or soon after starting treatment. We herein describe a 32 year-old patient with a 14-month history of headache and progressive visual loss. Her past medical history revealed pulmonary tuberculosis treated eight years before. A brain MRI showed a T1- and T2-weighted isointense contrast-enhancing lesion in the optic chiasm. A presumptive diagnosis of optochiasmatic tuberculoma was made and isoniazid, rifampin, pyrazinamide, and ethambutol were started. Despite treatment, the patient evolved to blindness. The prompt recognition of this condition is extremely important since the presence of optochiasmal enhancement is associated with blindness in patients with tuberculosis.

Primary Intradural Classic Chondrosarcoma: Case Report and Literature Review

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 420-423 ◽  
Author(s):  
Jark Jan Daniël Bosma ◽  
Ramez Wadie Kirollos ◽  
John Broome ◽  
Paul Richard Eldridge
Keyword(s):  
Case Report ◽  
Adjuvant Radiotherapy ◽  
Clinical Presentation ◽  
Malignant Potential ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Image Guided ◽  
History Of ◽  
Grade Ii ◽  
Exact Origin

Abstract OBJECTIVE AND IMPORTANCE The exact origin of rare intradural chondrosarcomas remains obscure. We present a case report of an intradural classic chondrosarcoma (a very rare subtype of chondrosarcoma in this location), with a review of the literature, in an attempt to clarify the histogenesis of these tumors. CLINICAL PRESENTATION A 48-year-old man presented with a 12-month history of progressive right hemiparesis. Computed tomography and magnetic resonance imaging demonstrated a left parietal space-occupying lesion. INTERVENTION The patient underwent an image-guided, left parietal parasagittal craniotomy. An extrinsic tumor, which seemed to arise from the dura, was macroscopically removed. There was no bone involvement. The histological examination revealed a Grade II classic chondrosarcoma with tumor infiltration into the dura. Adjuvant radiotherapy was administered. CONCLUSION Intradural chondrosarcomas are rare tumors, the majority of which are mesenchymal. Classic chondrosarcomas in this location are much rarer. Their histogenesis is uncertain. In this case, the origin seems to be from the dura. Because of the malignant potential of these tumors, radical extirpation whenever possible, followed by radiotherapy, is indicated.

Trigeminal Neuralgia Caused by a Pontine Abscess: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. E1450-E1452 ◽  
Author(s):  
Ahmet Bekar ◽  
Hasan Kocaeli ◽  
Emel Yilmaz ◽  
Şeref Doğan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Sphenoid Sinus ◽  
Clinical Presentation ◽  
Resonance Imaging ◽  
Repeat Magnetic Resonance Imaging ◽  
Corneal Reflex ◽  
History Of ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: Various intracranial abnormalities, including infectious conditions, may manifest as trigeminal neuralgia. CLINICAL PRESENTATION: A 33-year-old man presented with a 15-day history of right-sided facial pain and numbness. Neurological examination revealed diminished corneal reflex and facial sensation in the right V1–V2 distribution. Magnetic resonance imaging revealed a contrast-enhancing lesion centered at the right pons with extension of the enhancement to the sphenoid sinus. INTERVENTION: Broad-spectrum antibiotics were administered for 6 weeks. This resulted in alleviation of symptoms and resolution of the lesion as revealed by repeat magnetic resonance imaging. CONCLUSION: Presentation of a pons abscess with trigeminal neuralgia is rare, and to the best of our knowledge has not been reported previously. The patient was treated successfully with antibiotics alone.

Glomus tumour of the iris: A case report

2020 ◽  
pp. 112067212095903
Author(s):  
Huang Jing ◽  
Chen Weiwen ◽  
Cui Meihong ◽  
Guo Xiaohong
Keyword(s):  
Glomus Tumour ◽  
Histopathological Analysis ◽  
Case Description ◽  
Resonance Imaging ◽  
Blurred Vision ◽  
Ultrasound Computed Tomography ◽  
Adjacent Structures ◽  
History Of ◽  
Benign Tumours ◽  
Glomus Body

Introduction: Glomus tumours are rare benign tumours formed by modified smooth muscle cells arising from the glomus body. Glomus tumours occurring in the iris have not been previously reported. Case description: A 32-year-old woman presented with a 9-day history of blurred vision in her right eye. Ultrasound, computed tomography and magnetic resonance imaging confirmed the presence of a mass lesion within the iris. Surgery of the iris was performed and the tumour was removed. Histopathological analysis confirmed a glomus tumour. The patient remains clinically stable 5 months following surgery and has experienced no tumour recurrence. Conclusion: The findings from this case suggest that the typical symptoms of a glomus tumour may be absent in some cases, and that imaging examinations can help in understanding the extent of the lesion and the involvement of adjacent structures. Moreover, pathology and immunohistochemistry are crucial to confirm the diagnosis.

scholarly journals Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 239-241
Author(s):  
Mary Starrs ◽  
Onur Yenigun
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Adverse Reactions ◽  
Clinical Presentation ◽  
Use Case ◽  
Resonance Imaging ◽  
Cerebellar Dysfunction ◽  
History Of ◽  
The Central Nervous System ◽  
Local Emergency Department

Introduction: Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use. Case Report: We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn’s disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient’s symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two. Conclusion: Metronidazole-induced encephalopathy is a rare cause of vertigo and ataxia that can lead to permanent sequela if not identified and treated promptly. Thus, it is important for physicians to keep this diagnosis in mind when evaluating patients on metronidazole who present to the ED with new neurologic complaints.

Primary Myxopapillary Ependymoma of the Medulla

Neurosurgery ◽  
2010 ◽  
Vol 66 (6) ◽  
pp. E1208-E1209 ◽  
Author(s):  
Michael L. DiLuna ◽  
Gillian H. Levy ◽  
Shreya Sood ◽  
Charles C. Duncan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Fourth Ventricle ◽  
Clinical Presentation ◽  
Conus Medullaris ◽  
Myxopapillary Ependymoma ◽  
Filum Terminale ◽  
Resonance Imaging ◽  
Total Resection ◽  
Suboccipital Craniotomy ◽  
History Of

Abstract OBJECTIVE Myxopapillary ependymoma is a subclassification of ependymoma that is thought to be nearly exclusive to the conus medullaris or filum terminale. Primary intracerebral or brainstem myxopapillary ependymomas are rare. CLINICAL PRESENTATION An 8-year-old child presented with a 5-month history of nausea and vomiting and a 1-week history of headache. Magnetic resonance imaging revealed a nodular mass in the medulla with an associated cyst extending into the fourth ventricle. INTERVENTION A suboccipital craniotomy was performed, and a gross total resection of the lesion and cyst was achieved. Histological examination confirmed the diagnosis of myxopapillary ependymoma. A discussion of other reported cases of extraspinal myxopapillary ependymomas is presented. CONCLUSION This is the first report of a case of myxopapillary ependymoma, confirmed by histology, in the medulla. Although rare, myxopapillary ependymomas outside of the filum terminale do exist.

AN ASTROBLASTOMA MIMICKING A CAVERNOUS MALFORMATION

Neurosurgery ◽  
2007 ◽  
Vol 60 (3) ◽  
pp. E569-E270 ◽  
Author(s):  
Luis M. Tumialán ◽  
Daniel J. Brat ◽  
Arthur J. Fountain ◽  
Daniel L. Barrow
Keyword(s):  
Image Guidance ◽  
Clinical Presentation ◽  
Cavernous Malformation ◽  
Vascular Lesion ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Increased Intracranial Pressure ◽  
Radiographic Findings ◽  
History Of ◽  
Radiographic Data

Abstract OBJECTIVE Astroblastomas are rare glial neoplasms that usually occur in young adults and have a predilection for the cerebral hemispheres. Patients typically present with signs of increased intracranial pressure and seizures. Imaging studies reveal circumscribed, contrast-enhancing tumors that contain both cystic and solid components with variable peritumoral edema. Hemorrhage, which suggested the presence of a vascular lesion in this patient, has not been previously described as a feature of this neoplasm. CLINICAL PRESENTATION The authors report the case of a 33-year-old woman who presented with spontaneous intraparenchymal hemorrhage. The collective radiographic data suggested the presence of a cavernous malformation. INTERVENTION A right frontotemporal craniotomy was performed under frameless stereotactic image guidance. An astroblastoma was diagnosed after resection and neuropathological examination. CONCLUSION A rare radiological to pathological correlation of astroblastoma is presented in which the evolving hematoma, as observed on magnetic resonance imaging scans, complicated the radiographic diagnosis of this lesion. The clinical, radiographic, and pathological features of astroblastomas, as well as the natural history of these rare glial neoplasms, are reviewed. This case illustrates the capacity of astroblastomas to hemorrhage, disguising the classic radiographic findings typical of this glial neoplasm.

Rare Primary Embryonal Carcinoma in the Brachial Plexus: A Case Report and Literature Review

Neurosurgery ◽  
2019 ◽  
Vol 87 (2) ◽  
pp. E152-E155 ◽  
Author(s):  
Huihao Chen ◽  
Gang Yin ◽  
Na Cui ◽  
Haodong Lin
Keyword(s):  
Brachial Plexus ◽  
Embryonal Carcinoma ◽  
Clinical Presentation ◽  
Middle Part ◽  
Resonance Imaging ◽  
Primary Tumors ◽  
Nerve Sheath Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
History Of

Abstract BACKGROUND AND IMPORTANCE Primary tumors of the brachial plexus are rare. Most are benign and characterized as Schwannoma and neurofibroma, whereas malignant peripheral nerve sheath tumors are less common. Here, we report a rare case of primary embryonal carcinoma in the brachial plexus. CLINICAL PRESENTATION A 17-yr-old male presented with a 3-mo history of a mass growing in the left supraclavicular region over the middle part of the clavicle. Magnetic resonance imaging revealed a well-defined mass (diameter 2.5 cm) straddling the brachial plexus. After surgical resection, and the mass was histologically confirmed to be an embryonal carcinoma. CONCLUSION Primary embryonal carcinoma in the brachial plexus has not been reported previously. This case highlights the importance of considering the possibility that some primary brachial plexus tumors may be malignant and should be treated promptly.

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