scholarly journals Resolution of Radiation-Induced Necrosis in Arteriovenous Malformation with Bevacizumab: A Case Report and Review of Current Literature

2021 ◽  
pp. 297-304
Author(s):  
Forrest Kwong ◽  
Daphne B. Scarpelli ◽  
Ramon F. Barajas ◽  
Debra Monaco ◽  
James A. Tanyi ◽  
...  
Keyword(s):  
Linear Accelerator ◽  
Symptom Control ◽  
Resonance Imaging ◽  
Initial Management ◽  
Radiation Induced ◽  
Added Benefit ◽  
Martin Grade ◽  
Magnetic Resonance Imaging Mri ◽  
Viable Treatment

Stereotactic radiosurgery (SRS) is a proven treatment modality for inoperable arteriovenous malformations (AVMs). However, the rate of radiation-induced necrosis (RIN) is as high as 10%. A 6-year-old female patient presented with severe headache, emesis, and syncope, and workup revealed a Spetzler-Martin grade 4 AVM with intraventricular hemorrhage and hydrocephalus. The patient underwent a right frontal ventriculostomy followed by a linear accelerator-based SRS of 16.9 Gy. At 19 years, she developed progressive neurological symptoms. Diagnostic magnetic resonance imaging (MRI) revealed a recurrent parietal AVM nidus. We delivered the linear accelerator-based SRS of 18.5 Gy to the AVM nidus. Within 9 months, she experienced episodic headaches and left-sided weakness and spasticity; symptoms were initially managed with dexamethasone. Follow-up MRI was notable for edema and nondetectable blood flow, consistent with RIN and AVM obliteration. The second course of steroids did not provide the symptom control. Persistent RIN was noted on MRI, and she had stigmata of steroid toxicity (centripetal obesity, depression, and sleep disorder). Two infusions of bevacizumab (5 mg/kg) were administered concurrently with a tapering dose of dexamethasone. The patient noted a near immediate improvement in her headaches, and 2 months following the second bevacizumab infusion, she reported a near-complete resolution of her symptoms and displayed improved ambulation. The development of RIN remains a noteworthy concern post-SRS of AVMs. While steroids aid with initial management of RIN, for persistent and recurrent symptoms, bevacizumab infusions serve as a viable treatment course, with the added benefit of reducing the likelihood of adverse effects resulting from prolonged steroid therapy.

Magnetic Resonance Imaging Findings of Radiation-induced Changes After Treatment of Malignant Gliomas and Metastases with a Particular Emphasis on Radiation Necrosis

2011 ◽  
Vol 6 (2) ◽  
pp. 132
Author(s):  
Raquel Cano Alonso ◽  
Mar Jimenez de la Peña ◽  
Manuel Recio Rodriguez ◽  
Javier Carrascoso Arranz ◽  
Vicente Martinez de Vega Fernandez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Radiation Necrosis ◽  
Combined Therapy ◽  
Malignant Gliomas ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Radiation Induced ◽  
Magnetic Resonance Imaging Mri

New contrast-enhancing lesions discovered on routine follow-up brain imaging at or near the site of previously treated primary or metastatic brain tumours represent a clinical and radiological challenge, as radiation necrosis and tumoral recurrence often present at standard magnetic resonance imaging (MRI) with overlapping imaging features. Since the advent of combined therapy, including surgery and/or radiotherapy and chemotherapy, the post-treatment radiological assessment has been made earlier, with a subsequent higher incidence of early radionecrosis and a potential risk of mistaking it for disease progression. Therefore, both clinical and imaging follow-up are essential. This article briefly describes and illustrates the temporal patterns and spectrum of MR findings of radiation-induced brain injury and considers practical aspects of conventional and advanced MR sequences (diffusion-weighted imaging, perfusion MR and MR spectroscopy), with a particular emphasis on the distinction between tumoral recurrence and radiation necrosis.

Magnetic Resonance Imaging Findings of Radiation-induced Changes After Treatment of Malignant Gliomas and Metastases with a Particular Emphasis on Radiation Necrosis

2011 ◽  
Vol 07 (01) ◽  
pp. 53
Author(s):  
Raquel Cano Alonso ◽  
Mar Jimenez de la Peña ◽  
Manuel Recio Rodriguez ◽  
Javier Carrascoso Arranz ◽  
Vicente Martinez de Vega Fernandez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Radiation Necrosis ◽  
Combined Therapy ◽  
Malignant Gliomas ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Radiation Induced ◽  
Magnetic Resonance Imaging Mri

New contrast-enhancing lesions discovered on routine follow-up brain imaging at or near the site of previously treated primary or metastatic brain tumours represent a clinical and radiological challenge, as radiation necrosis and tumoral recurrence often present at standard magnetic resonance imaging (MRI) with overlapping imaging features. Since the advent of combined therapy, including surgery and/or radiotherapy and chemotherapy, the post-treatment radiological assessment has been made earlier, with a subsequent higher incidence of early radionecrosis and a potential risk of mistaking it for disease progression. Therefore, both clinical and imaging follow-up are essential. This article briefly describes and illustrates the temporal patterns and spectrum of MR findings of radiation-induced brain injury and considers practical aspects of conventional and advanced MR sequences (diffusion-weighted imaging, perfusion MR and MR spectroscopy), with a particular emphasis on the distinction between tumoral recurrence and radiation necrosis.

Magnetic Resonance Imaging (MRI) Diagnosis of Fetal Corpus Callosum Abnormalities and Follow-up Analysis

2021 ◽  
pp. 088307382110162
Author(s):  
Xu Li ◽  
Qing Wang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Corpus Callosum ◽  
Resonance Imaging ◽  
Neurodevelopmental Delay ◽  
Mri Diagnosis ◽  
Magnetic Resonance Imaging Mri ◽  
Lost To Follow Up ◽  
Singleton Pregnancies

Objectives: We analyzed the magnetic resonance imaging (MRI) manifestations of fetal corpus callosum abnormalities and discussed their prognosis based on the results of postnatal follow up. Methods: One hundred fifty-five fetuses were diagnosed with corpus callosum abnormalities by MRI at our hospital from 2004 to 2019. Gesell Development Scales were used to evaluate the prognosis of corpus callosum abnormalities after birth. Results: Corpus callosum abnormalities were diagnosed in 149 fetuses from singleton pregnancies, and 6 pairs of twins, 1 in each pair is a corpus callosum abnormality. Twenty-seven cases (27/155) were lost to follow up, whereas 128 cases (128/155) were followed up. Of these, 101 cases were induced for labor, whereas 27 cases were born naturally. Among the 27 cases of corpus callosum abnormality after birth, 22 cases were from singleton pregnancies (22/27). Moreover, 1 twin from each of 5 pairs of twins (5/27) demonstrated corpus callosum abnormalities. The average Gesell Development Scale score was 87.1 in 19 cases of agenesis of the corpus callosum and 74.9 in 3 cases of hypoplasia of the corpus callosum. Among the 5 affected twins, 2 had severe neurodevelopmental delay, 2 had mild neurodevelopmental delay, and 1 was premature and died. Conclusion: The overall prognosis of agenesis of the corpus callosum is good in singleton pregnancies. Hypoplasia of the corpus callosum is often observed with other abnormalities, and the development quotient of hypoplasia of the corpus callosum is lower compared with agenesis of the corpus callosum. Corpus callosum abnormalities may occur in one twin, in whom the risk may be increased.

scholarly journals Bone marrow abnormalities detected by magnetic resonance imaging as initial sign of hematologic malignancies

2018 ◽  
Author(s):  
Ida Sofie Grønningsæter ◽  
Aymen Bushra Ahmed ◽  
Nils Vetti ◽  
Silje Johansen ◽  
Øystein Bruserud ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Cell Types ◽  
Hematologic Malignancies ◽  
Resonance Imaging ◽  
Initial Sign ◽  
Magnetic Resonance Imaging Mri

The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.

scholarly journals Multifocal Balo's Concentric Sclerosis in Children: Report of a Case and Review of Literature

2017 ◽  
Vol 08 (S 01) ◽  
pp. S136-S138
Author(s):  
Sanjeev Kumar Bhoi ◽  
Suprava Naik ◽  
Jayantee Kalita ◽  
U. K. Misra
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Acute Disseminated Encephalomyelitis ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
Concentric Pattern ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Post Infectious

ABSTRACTBalo's concentric sclerosis (BCS) is a rare demyelinating lesion considered to be a variant of multiple sclerosis (MS). On magnetic resonance imaging (MRI) Balo's concentric sclerosis shows the typical concentric pattern. We report a case of 10 year old child with BCS who presented as post infectious acute disseminated encephalomyelitis (ADEM). He is asymptomatic and had no relapse after 6 years of follow-up.

scholarly journals Short-lasting unilateral neuralgiform headache with autonomic symptoms associated with idiopathic hypertrophic pachymeningitis

2018 ◽  
Vol 1 ◽  
pp. 251581631879054
Author(s):  
J Matthijs Biesbroek ◽  
Dirk R Rutgers ◽  
Sander van Gulik ◽  
Catherina JM Frijns
Keyword(s):  
Brain Mri ◽  
Resonance Imaging ◽  
Hypertrophic Pachymeningitis ◽  
Trigeminal Autonomic Cephalalgia ◽  
Autonomic Symptoms ◽  
Meningeal Inflammation ◽  
Magnetic Resonance Imaging Mri ◽  
Multiple Episodes ◽  
Rule Out

Short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA) is a rare form of trigeminal autonomic cephalalgia. SUNA is frequently associated with a trigeminal neurovascular conflict and rarely occurs secondary to other intracranial pathology. We report a patient with SUNA that was associated with ipsilateral meningeal inflammation caused by idiopathic hypertrophic pachymeningitis (HP). During the 9-year follow-up, she experienced multiple episodes of SUNA, most of which occurred during exacerbations of the pachymeningitis. This is the third case of SUNA associated with HP reported in the literature. Based on this observation, we suggest that in patients presenting with SUNA, besides dedicated magnetic resonance imaging (MRI) of the trigeminal nerve, gadolinium-enhanced brain MRI should be performed to rule out HP.

scholarly journals Pineocytoma with diffuse dissemination to the leptomeninges

Rare Tumors ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 163-165 ◽  
Author(s):  
Caitlin Gomez ◽  
Jeffrey Wu ◽  
Whitney Pope ◽  
Harry Vinters ◽  
Antonio DeSalles ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Radiotherapy ◽  
Leptomeningeal Dissemination ◽  
Resonance Imaging ◽  
Pineal Parenchymal Tumors ◽  
Craniospinal Radiation ◽  
Long Term Follow Up ◽  
Magnetic Resonance Imaging Mri

Pineal parenchymal tumors are rare. Of the three types of pineal parenchymal tumors, pineocytomas are the least aggressive and are not known to diffusely disseminate. In this paper, we report the successful treatment of a case of pineocytoma with diffuse leptomeningeal relapse following initial stereotactic radiotherapy. A 39-year-old female presented with headaches, balance impairment, urinary incontinence, and blunted affect. A pineal mass was discovered on magnetic resonance imaging (MRI). A diagnosis of pineocytoma was established with an endoscopic pineal gland biopsy, and the patient received stereotactic radiotherapy. Ten years later, she developed diffuse leptomeningeal dissemination. The patient was then successfully treated with craniospinal radiation therapy. Leptomeningeal spread may develop as late as 10 years after initial presentation of pineocytoma. Our case demonstrates the importance of long-term follow-up of patients with pineal parenchymal tumors following radiation therapy, and the efficacy of craniospinal radiation in the treatment of leptomeningeal dissemination.

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