scholarly journals Melioidosis with endocarditis and massive cerebral infarct

2015 ◽  
Vol 10 (1) ◽  
pp. 55 ◽  
Author(s):  
Mansoor C. Abdulla ◽  
Jemshad Alungal
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Burkholderia Pseudomallei ◽  
Liver Lesion ◽  
Cystic Lesions ◽  
Middle Cerebral Artery Territory ◽  
Resonance Imaging ◽  
Ct Guided ◽  
Magnetic Resonance Imaging Mri ◽  
Upper Abdominal

Endocarditis due to melioidosis is rare. A 60-year-old male was admitted with upper abdominal pain and vomiting for one month. Contrast enhancing computed tomography (CT) of the abdomen showed multiple hepatic, splenic and pancreatic nonenhancing cystic lesions. Culture of CT guided aspirate from the liver lesion showed growth of <em>Burkholderia pseudomallei</em>. He was started on ceftazidime and cotrimoxazole. Four days after admission patient developed decreased speech and response. Magnetic resonance imaging (MRI) and MR angioram brain showed massive infarct in the middle cerebral artery territory and occlusion of the middle cerebral artery. Echocardiogram showed vegetation in the aortic valve. He was diagnosed to have disseminated melioidosis with endocarditis resulting in massive infarct in the middle cerebral artery territory.

scholarly journals Coincident craniopharyngioma and unruptured aneurysm at the right M1- M2 segment of the middle cerebral artery. Case report 1

2019 ◽  
Vol 29 (01) ◽  
pp. 35-39
Author(s):  
Williams Escalante ◽  
Denis Isao Ueoka ◽  
Eduardo Andre Goulart de Alcântara ◽  
Anderson Rodrigo de Sousa ◽  
Paulo Henrique Pires de Aguiar ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Unruptured Aneurysm ◽  
Vascular Lesions ◽  
Resonance Imaging ◽  
Surgical Time ◽  
Appropriate Treatment ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

We report a case of coincident craniopharyngioma with an unruptured aneurysm at the right M1- M2 segment of the middle cerebral artery; and discuss the surgical approach to two different pathologies treated at same surgical time, as well as current theories to explain the coincidence or association between tumor and vascular lesions at the sellar and suprasellar regions. The patient was a 59-year-old woman; with a history of visual impairment and headache. Both lesions were identified by magnetic resonance imaging (MRI) and cerebral angiography, and were treated surgically. We suggest individualized treatment for each case, choosing the best neurosurgical approach to achieve an appropriate treatment of both pathologies in the same operative session.

scholarly journals A243 A RETROSPECTIVE REVIEW OF THE RADIOGRAPHIC DIAGNOSIS AND SURGICAL RESECTION RATES OF PANCREATIC SEROUS CYSTS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 300-301
Author(s):  
M Monachese ◽  
S Li ◽  
M Salim ◽  
L Guimaraes ◽  
P D James
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Surgical Resection ◽  
Predictive Value ◽  
Resected Specimen ◽  
Cystic Lesions ◽  
Resonance Imaging ◽  
Guided Biopsy ◽  
Magnetic Resonance Imaging Mri

Abstract Background Pancreatic cystic lesions are increasingly identified in persons undergoing abdominal imaging. Serous cystic neoplasms (SCNs) have a very low risk of malignant transformation. Resection of SCNs is not recommended in the absence of related symptoms. The accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) to identify SCNs is not known and may impact clinical care. Aims To evaluate the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis of SCN. To see how this can impact the decision to resect suspected SCNs. Methods Retrospective cohort study of patients from the University Health Network with suspected SCNs from 2017–2020 who underwent either a CT or MRI of the abdomen. Reports noting pancreatic cystic lesions were identified and reviewed. Only cases with suspected SCNs were included. Clinical (age, sex, symptoms, treatment) and radiographic (type of imaging, reported cyst characteristics) data was collected. Pathology was reviewed for all cases where the cysts was biopsied or resected during follow-up. The gold standard for the diagnosis for SCN was pathology of resected specimen or EUS-guided biopsy cytopathology showing no evidence of a mucinous lesion, CEA level below 10ug per L and amylase level below 50 U/L. Results 163 patients were included in the study. 99 (61%) were female and 98 (60%) underwent CT scan. EUS-guided biopsy was performed in 24 (15%) of patients and 8 (5%) had surgical resection. Multidisciplinary review was performed in 6 of the 8 cases that went to surgery. Of the resected specimens, 5 (63%) were SCN, 1 was a mucinous cystic lesion, 1 was a neuroendocrine tumor and 1 was a carcinoma. Two patients underwent EUS evaluation prior to surgical resection. In one case SCN was resected when EUS reported an undetermined cyst type. Reasons for surgical resection were: the diagnosis of serous cyst was not definitive (n=5), symptoms (n=2), and high-risk mucinous cystic neoplasm identified on EUS (n=1). Of 30 patients with pathology available, 15 (50%) were confirmed to have a SCN. CT and MRI had a sensitivity, specificity, positive predictive value and negative predictive value of 93%, 25%, 52% and 80%, respectively. Conclusions Surgical resection for SCN lesions is driven by diagnostic uncertainty after cross-sectional imaging. Multidisciplinary review and EUS evaluation may improve diagnostic accuracy and should be considered prior to surgical resection of possible SCN lesions. Funding Agencies None

scholarly journals The anesthetic approach for endovascular recanalization therapy depends on the lesion site in acute ischemic stroke

2021 ◽  
Author(s):  
Kilian Fröhlich ◽  
Gabriela Siedler ◽  
Svenja Stoll ◽  
Kosmas Macha ◽  
Thomas M. Kinfe ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Cerebral Artery ◽  
Posterior Circulation ◽  
Neurological Deficits ◽  
Stroke Severity ◽  
Lesion Volume ◽  
Middle Cerebral Artery Territory ◽  
Cerebral Lesion

Abstract Purpose Endovascular therapy (EVT) of large-vessel occlusion in acute ischemic stroke (AIS) may be performed in general anesthesia (GA) or conscious sedation (CS). We intended to determine the contribution of ischemic cerebral lesion sites on the physician’s decision between GA and CS using voxel-based lesion symptom mapping (VLSM). Methods In a prospective local database, we sought patients with documented AIS and EVT. Age, stroke severity, lesion volume, vigilance, and aphasia scores were compared between EVT patients with GA and CS. The ischemic lesions were analyzed on CT or MRI scans and transformed into stereotaxic space. We determined the lesion overlap and assessed whether GA or CS is associated with specific cerebral lesion sites using the voxel-wise Liebermeister test. Results One hundred seventy-nine patients with AIS and EVT were included in the analysis. The VLSM analysis yielded associations between GA and ischemic lesions in the left hemispheric middle cerebral artery territory and posterior circulation areas. Stroke severity and lesion volume were significantly higher in the GA group. The prevalence of aphasia and aphasia severity was significantly higher and parameters of vigilance lower in the GA group. Conclusions The VLSM analysis showed associations between GA and ischemic lesions in the left hemispheric middle cerebral artery territory and posterior circulation areas including the thalamus that are known to cause neurologic deficits, such as aphasia or compromised vigilance, in AIS-patients with EVT. Our data suggest that higher disability, clinical impairment due to neurological deficits like aphasia, or reduced alertness of affected patients may influence the physician’s decision on using GA in EVT.

scholarly journals Canine Choroid Plexus Tumor with Intracranial Dissemination Presenting as Multiple Cystic Lesions

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Trisha J. Oura ◽  
Peter J. Early ◽  
Samuel H. Jennings ◽  
Melissa J. Lewis ◽  
Jeremy R. Tobias ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Brain Lesions ◽  
Behavioral Changes ◽  
Cystic Lesions ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Choroid Plexus Tumor ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Characteristics ◽  
Possible Cause

A Miniature Pinscher developed acute blindness and behavioral changes. On magnetic resonance imaging (MRI), there were multiple small intra-axial cystic lesions, and primary differential diagnoses included primary or metastatic neoplasia and neurocysticercosis. These cystic lesions were subsequently diagnosed histopathologically as disseminated choroid plexus carcinoma. This is only the second documented description of this diagnosis in a dog, but both patients had very similar MRI findings. This patient adds to the literature about the MRI characteristics of choroid plexus tumors and indicates that choroid plexus tumor should be considered as a possible cause of small multifocal intra-axial cystic brain lesions in dogs, regardless of whether a primary intraventricular lesion is visible.

Susceptibility-diffusion mismatch in middle cerebral artery territory acute ischemic stroke: clinical and imaging implications

2016 ◽  
Vol 58 (7) ◽  
pp. 876-882 ◽  
Author(s):  
Seyedmehid Payabvash ◽  
Shayandokht Taleb ◽  
John C Benson ◽  
Benjamin Hoffman ◽  
Mark C Oswood ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Cerebral Artery ◽  
Middle Cerebral Artery Territory

scholarly journals Comparison of Ischemic and Hemorrhagic Stroke in the Medical Ward of Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Hussen Abdu ◽  
Fentaw Tadese ◽  
Girma Seyoum
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Hemorrhagic Stroke ◽  
Medical Ward ◽  
Body Parts ◽  
Middle Cerebral Artery Territory ◽  
Common Site ◽  
Stroke Patients ◽  
Stroke Subtypes

Background. Distinguishing the category of stroke plays a vital role in planning patient care. Simple clinical findings help distinguish the type of stroke. However, there is a need for diagnostic imaging. In Ethiopia, stroke is the most common neurological condition in patients admitted to hospitals. Yet, there are limited data on comparisons of stroke subtypes. Thus, this study was designed to determine the prevalence of stroke and to compare ischemic and hemorrhagic strokes. Methods. A retrospective cross-sectional study design was employed. Medical records containing complete information and confirmed diagnosis using imaging techniques were included. The data were entered into SPSS version 24.0 for analysis. Results with a P value of <0.05 were considered statistically significant. Results. From a total of 312 stroke patients, 204 (65.4%) patients were admitted due to ischemic stroke. More females, 59 (18.9%), were admitted for hemorrhagic stroke than males. In both ischemic, 175 (56.1%) and hemorrhagic, 91 (29.2%) stroke cases, most of the patients were 45 years and above. Middle cerebral artery territory was the most common site of arterial territory infarctions in ischemic stroke, 158 (50.7%). Middle cerebral artery territory also was the most common site of hematoma in hemorrhagic stroke, 91 (29.2%). Infarctions in more than one lobe of the cerebrum (16.4%) and intracerebral hemorrhage in multiple areas of the cerebrum (7.4%) were observed in ischemic as well as hemorrhagic stroke cases. Most of the ischemic, 124 (39.8%), and hemorrhagic, 39 (12.5%), stroke patients presented loss of sensation and weakness of body parts. Hypertension was observed in 124 (39.8%) ischemic and 73 (23.4%) hemorrhagic stroke patients. The mortality rate of ischemic stroke, 47 (15.3%), was two times higher than hemorrhagic stroke, 20 (6.5%). Hypertension was the most common predictor of death in both ischemic and hemorrhagic stroke cases. Conclusions. Ischemic stroke is a common type of stroke in the medical ward of the study hospital. More females were affected by hemorrhagic stroke than males. Middle cerebral artery territory was the most affected area of the brain in both ischemic and hemorrhagic strokes. Most ischemic and hemorrhagic stroke patients were admitted due to loss of sensation and weakness of body parts. Hypertension was the most common risk factor of stroke as well as a predictor of stroke-related deaths. Identification of the stroke subtypes may be important in the management of stroke. Thus, health professionals, government officials, community leaders, and the population at large could be involved in creating awareness about antecedent risk factors and clinical presentations of stroke subtypes.

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