A Dorsally Located Endodermal Cyst in the Foramen Magnum Mimicking an Arachnoid Cyst: A Case Report

2020 ◽  
Vol 55 (4) ◽  
pp. 197-202
Author(s):  
Yoichiro Kawamura ◽  
Hiroshi Oketani ◽  
Masahiro Mizoguchi ◽  
Nobuhiro Hata ◽  
Satoshi O. Suzuki ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Arachnoid Cyst ◽  
Cyst Wall ◽  
Complete Recovery ◽  
Foramen Magnum ◽  
Magnetic Resonance Images ◽  
Limb Weakness ◽  
Cisterna Magna ◽  
Endodermal Cyst

<b><i>Introduction:</i></b> Endodermal cysts are congenital benign cystic lesions in the central nervous system and cause various symptoms. Although some have been reported in the posterior fossa, endodermal cysts located dorsal to the brainstem are extremely rare. <b><i>Case Presentation:</i></b> The case was of a 10-year-old girl who presented with bilateral upper limb weakness and tremor. Magnetic resonance imaging demonstrated a 4.5-cm cystic lesion with T1-weighted hypointense and T2-weighted hyperintense content in the midline of the cisterna magna dorsal to the medulla oblongata. The cyst was cerebrospinal fluid-like, causing us to suspect a symptomatic arachnoid cyst. The lucent cyst wall had no apparent attachment, and complete recovery ensued following total excision of the cyst wall. Pathology confirmed a diagnosis of endodermal cyst. <b><i>Discussion/Conclusion:</i></b> Herein, we review the past literature on this rare entity. An endodermal cyst in the cisterna magna tends to be less strongly attached and to show a cerebrospinal fluid-like component on magnetic resonance images that mimics an arachnoid cyst. The characteristics of dorsally located endodermal cysts may differ from those in other locations.

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.

Paraplegia after a Routine Lumbar Laminectomy: Report of a Rare Complication and Successful Management

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 638-640 ◽  
Author(s):  
Patrick L. Valls ◽  
Gill L. Naul ◽  
Steven L. Kanter
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Arachnoid Cyst ◽  
Spinal Canal ◽  
Rare Complication ◽  
Resonance Imaging ◽  
Thoracic Spinal

Abstract Arachnoid cysts of the spinal canal are relatively common lesions that may be either intra- or extradural. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots. We report a case in which an intradural thoracic arachnoid cyst became symptomatic after a routine decompressive lumbar laminectomy for spinal stenosis. Myelography revealed no abnormality, although magnetic resonance imaging and computed tomography after myelography demonstrated a mass within the posterior aspect of the thoracic spinal canal associated with anterior displacement and compression of the spinal cord. A change in the flow dynamics of the cerebrospinal fluid probably allowed the development of spinal cord compression due to one of the following: expansion of the cyst, decreased cerebrospinal fluid buffer between the cord and the cyst, or epidural venous engorgement. A concomitant and more cephalad lesion such as an arachnoid cyst should be considered when myelopathic complications arise after lumbar surgery. Magnetic resonance imaging and computed tomography after myelography are useful to demonstrate the additional pathological processes.

Influence of Lumbosacral Cerebrospinal Fluid Density, Velocity, and Volume on Extent and Duration of Plain Bupivacaine Spinal Anesthesia

2004 ◽  
Vol 100 (1) ◽  
pp. 106-114 ◽  
Author(s):  
Hideyuki Higuchi ◽  
Jyun-ichi Hirata ◽  
Yushi Adachi ◽  
Tomiei Kazama
Keyword(s):  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Spinal Anesthesia ◽  
Onset Time ◽  
Inverse Correlation ◽  
Sensory Block ◽  
Magnetic Resonance Images ◽  
Spinal Block ◽  
Linear Regression Models ◽  
Block Level

Background The current study was designed to investigate the influence of lumbosacral cerebrospinal fluid (CSF) density, velocity, and volume on the extent and duration of plain bupivacaine spinal anesthesia. Methods Forty-one patients scheduled to undergo orthopedic surgery with spinal block were enrolled. Lumbosacral CSF volumes were calculated from low thoracic, lumbar, and sacral axial magnetic resonance images. CSF velocity at the L3-L4 level was derived from phase-contrast magnetic resonance images. Spinal anesthesia was performed in the lateral decubitus position. CSF (2 ml) was sampled to measure CSF density before injection of 3 ml plain bupivacaine (0.5%). Statistical correlation coefficients (rho) between CSF characteristics and measurements of spinal anesthesia were assessed by Spearman rank correlation. In addition, stepwise multiple linear regression models were used to select important predictors of measures of spinal anesthesia. Results There was a significant correlation between CSF density and peak sensory block level (rho = 0.33, P = 0.034). Lumbosacral CSF volume inversely correlated with peak sensory block level (rho = -0.65, P &lt; 0.0001) and positively correlated with onset time of complete motor block (rho = 0.42, P = 0.008). CSF volume also inversely correlated with time required for regression of the sensory block to L1 (rho = -0.35, P = 0.026) and L2 (rho = -0.33, P = 0.039). There was a significant inverse correlation between peak diastolic CSF velocity and duration of motor blockade (rho = -0.44, P = 0.005). Multiple regression analysis revealed that weight and CSF volume significantly contributed to the peak sensory block level (R2 = 0.46). Conclusions These findings indicate that CSF density and volume influence the spread of spinal anesthesia with plain bupivacaine and that CSF volume also influences the duration of spinal anesthesia. CSF velocity might also influence the duration of plain bupivacaine spinal anesthesia.

Broadening the clinical spectrum: unusual presentation of spontaneous cerebrospinal fluid hypovolemia

2003 ◽  
Vol 98 (4) ◽  
pp. 903-907 ◽  
Author(s):  
Dennis A. Nowak ◽  
Sven-Olaf Rodiek ◽  
Jürgen Zinner ◽  
Albrecht Guhlmann ◽  
Helge Topka
Keyword(s):  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Clinical Presentation ◽  
Spontaneous Intracranial Hypotension ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Imaging Characteristics ◽  
Blood Patch ◽  
Csf Leakage ◽  
Fine Print

✓ The syndrome of spontaneous intracranial hypotension is characterized by orthostatic headaches in conjunction with reduced cerebrospinal fluid (CSF) pressure or CSF volume, and characteristic magnetic resonance (MR) imaging findings. A 50-year-old man presented with a 1-year history of paroxysmal ataxia of gait and short attacks of blurred vision when he stood up from a recumbent position and began to walk. Orthostatic headache was not a feature of his clinical presentation. Magnetic resonance images of the brain revealed diffuse enhancement of the dura mater and hygromas over both cerebral convexities. Magnetic resonance images of the spine demonstrated dilated cervical epidural veins and dilation of the perimedullary veins. Radionuclide cisternography identified a CSF leakage that was localized to the T12—L1 level on subsequent myelograms and on computerized tomography scans obtained after the myelograms. An epidural blood patch was administered and visualized with tungsten powder. The patient's clinical symptoms and sites of disease on imaging completely resolved. The unusual clinical presentation in this case—paroxysmal ataxia of gait, lack of orthostatic headaches, and dilated epidural and perimedullary venous plexus—supports a recently noted broadening of both the clinical and imaging characteristics of spontaneous intracranial hypovolemia.

scholarly journals Serial magnetic resonance imaging changes of pseudotumor lesions in retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuying Yan ◽  
Shuai Jiang ◽  
Ruilin Wang ◽  
Xiang Wang ◽  
Peng Li ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vision Loss ◽  
White Matter Lesions ◽  
Magnetic Resonance Images ◽  
Brain Lesions ◽  
Insertion Mutation ◽  
Imaging Data ◽  
Fundus Fluorescein Angiography ◽  
Limb Weakness ◽  
Systemic Manifestations

Abstract Background Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is an adult-onset rare monogenic microvasculopathy. Its typical neuroimaging features are punctate white matter lesions or pseudotumor alterations. RVCL-S is often under-recognized and misdiagnosed because of its rarity and similar imaging manifestations to multiple sclerosis or brain malignant mass. Case presentation Here we report a case of a 36-year-old Chinese man who developed multiple tumefactive brain lesions spanning over two years leading to motor aphasia, cognitive decline, and limb weakness. He also presented with slight vision loss, and fundus fluorescein angiography indicated retinal vasculopathy. He underwent brain biopsies twice and showed no evidence of malignancy. Given the family history that his father died of a brain mass of unclear etiology, RVCL-S was suspected, and genetic analysis confirmed the diagnosis with a heterozygous insertion mutation in the three-prime repair exonuclease 1 gene. He was given courses of corticosteroids and cyclophosphamide but received little response. Conclusions The present case is one of the few published reports of RVCL-S with two-year detailed imaging data. Serial magnetic resonance images showed the progression pattern of the lesions. Our experience emphasizes that a better understanding of RVCL-S and considering it as a differential diagnosis in patients with tumefactive brain lesions may help avoid unnecessary invasive examinations and make an earlier diagnosis.

Cyst of the Choroid Plexus in the Lateral Ventricle: Case Report and Review of the Literature

Neurosurgery ◽  
1990 ◽  
Vol 27 (3) ◽  
pp. 470-476 ◽  
Author(s):  
Genya Odake ◽  
Hiroshi Tenjin ◽  
Nobukuni Murakami
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Choroid Plexus ◽  
Cyst Wall ◽  
Lateral Ventricle ◽  
Magnetic Resonance Images ◽  
Review Of The Literature ◽  
Total Removal ◽  
Computed Tomographic ◽  
Intraventricular Cyst

Abstract We report an intraventricular cyst in a 2-year-old boy who had myoclonic jerks of the extremities. The cyst had no communication with the ventricular system or subarachnoid space. Total removal of the cyst adhering to the choroid plexus was accomplished. The glial cyst wall was lined in part by flattened or cuboidal epithelium. The preoperative and postoperative computed tomographic scans and magnetic resonance images are presented, and congenital benign cysts in the lateral ventricle are reviewed and discussed.

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