RESUMEN
Stereotactic biopsies for lesions in the brainstem and deep brain are rare. This study aimed to summarize our 6-year experience in the accurate diagnosis of lesions in the brain stem and deep brain and to discuss the technical note and strategies. From December 2011 to January 2018, 72 cases of intracranial lesions in the brainstem or deep in the lobes undergoing stereotactic biopsy were retrospectively reviewed. An individualized puncture path was designed based on the lesion's location and the image characteristics. The most common biopsy targets were deep in the lobes (43 cases, 59.7%), including frontal lobe (33 cases, 45.8%), temporal lobe (4 cases, 5.6%), parietal lobe (3 cases, 4.2%), and occipital lobe (3 cases, 4.2 %). There were 12 cases (16.7%) of the brainstem, including 8 cases (11.1%) of midbrain, and 4 cases (5.6%) of pons or brachium pontis. Other targets included internal capsule (2 cases, 2.8%), thalamus (3 cases, 4.2%), and basal ganglion (12 cases, 16.7%). As for complications, one patient developed acute intracerebral hemorrhage in the biopsy area at 2 h post-operation, and one patient had delayed intracerebral hemorrhage at 7 days post-operation. The remaining patients recovered well after surgery. There was no surgery-related death. The CT-MRI-guided stereotactic biopsy of lesions in the brainstem or deep in the brain has the advantages of high safety, accurate diagnosis, and low incidence of complications. It plays a crucial role in the diagnosis of atypical, microscopic, diffuse, multiple, and refractory lesions.
Asunto(s)
Humanos , Encéfalo/diagnóstico por imagen , Técnicas Estereotáxicas , Biopsia , Tronco Encefálico/diagnóstico por imagen , Estudios Retrospectivos , Biopsia Guiada por ImagenAsunto(s)
Humanos , Recién Nacido , Inmunoglobulina M/líquido cefalorraquídeo , Virus Zika/aislamiento & purificación , Infección por el Virus Zika/diagnóstico , Pérdida Auditiva Sensorineural/diagnóstico , Microcefalia/virología , Tronco Encefálico/diagnóstico por imagen , Tomógrafos Computarizados por Rayos X , Transmisión Vertical de Enfermedad Infecciosa , Pérdida Auditiva Sensorineural/virologíaAsunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Imagen por Resonancia Magnética/métodos , Encefalomielitis/diagnóstico por imagen , Tronco Encefálico/patología , Tronco Encefálico/diagnóstico por imagen , Enfermedad Crónica , Corticoesteroides/uso terapéutico , Diagnóstico Diferencial , Encefalomielitis/patología , Encefalomielitis/tratamiento farmacológico , Sistema Glinfático/diagnóstico por imagenRESUMEN
Chlorfenapyr is a widely used, moderately hazardous pesticide. Previous reports have indicated that chlorfenapyr intoxication can be fatal in humans. We reported the first non-fatal case of chlorfenapyr-induced toxic leukoencephalopathy in a 44-year-old female with resolution of extensive and abnormal signal intensities in white matter tracts throughout the brain, brain stem, and spinal cord on serial magnetic resonance imaging.