The rare association of leukoencephalopathy, cerebral calcifications, and cysts: case report / A associação rara de leucoencefalopatia, calcificações cerebrais e cistos: relato de caso

Although basal ganglia calcifications were described a long time ago,1,3,11 the association of leukoencephalopathy, cerebral calcifications, and cysts (LCC) is a very rare entity described in 1996.5 We present a new case of LCC and discuss clinical, neuroradiologic, and histopathologic findings regarding this association.

Mesmo que as calcificaçãoes dos núcleos da base tenham sido descritas há muito tempo atrás1,3,11 a associação com leucoencefalopatia, calcificações cerebrais e cistos (LCC) é uma entidade muito rara descrita em 1996.5 Nós apresentamos um caso novo de LCC e discutimos os achados clínicos, neurorradiológicos e histopatológicos relacionados a essa entidade.

Uso de estereotaxia en tuberculosis cerebral / Steeotactic use in cerebral tuberculosis

La Tuberculosis Cerebral es la presentación más inusual de tuberculosis extrapulmonar en países en vías de desarrollo, donde esta enfermedad tiene alta incidencia y prevalencia. La amplia presentación clínica y poca especificidad, dificultan el diagnóstico precoz, relacionándose directamente con mayor morbimortalidad en pacientes afectados. La estereotaxia es una técnica neuroquirúrgica mínimamente invasiva que permite la localización y acceso preciso a estructuras intracraneanas. Se presenta un caso de una mujer de 34 años con clínica de crisis epilépticas y cuya imagenología muestra lesión parietal quística cerebral profunda. Debido a los múltiples diagnósticos diferenciales, se realiza biopsia-aspiración estereotáxica, llegando al diagnóstico de tuberculosis cerebral. El tratamiento adecuado muestra resolución completa del cuadro a los 8 meses.

Cerebral Tuberculosis is the most unusual presentation of extrapulmonary tuberculosis, in developing countries where this disease has high incidence and prevalence. The broad clinical presentation and poor specificity difficult early diagnosis, related directly with higher lethality in affected patients. Stereotactic is a modern neurosurgery minimally invasive that allows accurate localization and access to intracranial structures. Case of a 34 years-old woman with seizures and imagenology that present intraparietal cystic deep brain lesión. Due multiple differential diagnoses an aspiration-biopsy stereotactic is made, reaching the diagnostic of cerebral tuberculosis. Treatment after 8 months shows complete resolution.

Progressively Enlarged Intracerebral Ependymal Cyst Presenting with Movement Disorder

Ependymal cysts are neuroepithelial cysts, typically found in the central white matter of the temporoparietal and frontal lobes. Clinical symptoms usually result from neurological deficits referable to these regions, from seizures, and chronic headaches associated with increased intracranial pressure. We describe here a case of ependymal cyst on the right fronto-parietal lobe, presenting with tremor and weakness. The cyst was resected surgically and presurgical neurological abnormalities were improved. An exploratory surgery with establishment of an adequate route of drainage and histological examination of the cyst wall are mandatory in the management of patients with a progressive and symptomatic intraparenchymal cyst.

CT and MR Imaging Findings of Subdural Dermoid Cyst Extending into the Right Foramen Ovale: A Case Report

Intracranial dermoid cyst is a rare congenital benign disease, representing less than 0.5% of primary brain tumors. Nevertheless, if ruptured spontaneously or during surgery, it has a poor prognosis due to chemical meningitis. Therefore, it is essential to perform accurate diagnosis and proper treatment. We report an intracranial subdural dermoid cyst that may be misdiagnosed as extracranial or epidural lesion because of extension into the right foramen ovale, and describe the CT and MR imaging findings.

MRI Findings of Intracranial Neurenteric Cyst: Cast Report

Neurenteric cyst is very rare congenital disease and usually presents symptoms in adulthood. It can cause major neurological deficits if detection and treatment are delayed. It is also known to be a source of serious infection of the central nervous system. Neurenteric cyst is usually located in the ventral aspect of the lower cervical or upper thoracic spinal cord. Intracranial neurenteric cyst is very uncommon and less than 35 cases have been reported in the literature. We report MRI findings of two cases of intracranial neurenteric cyst and review the literature.

Intracranial Neurenteric Cyst: A Case Report and Review of the Literature

Neurenteric cyst is an extremely rare developmental cyst of the central nervous system. It is lined withintestinal epithelium and is usually found in the subarachnoid space of the cervical and thoracic spine. We reporta case of intracranial neurenteric cyst in a 40-year-old man, and describe the MRI findings. This modality showeda large cyst, ventral to the pons and extending bilaterally to the cerebellopontine angles and craniovertebraljunction;its signal was hyperintense on both T-1and T2-weighted images and there is no enhancement on postcontrastT1-weighted images.

Supratentorial Cystic Intracranial Lesions: MR Imaging Features

PURPOSE: To describe MR findings and differential points of supratentorial cystic intracranial lesions. MATERIALS AND METHODS: We retrospectively reviewed and analyzed the MR findings of 59 patients with supratentorial cystic intracranial lesions, and classified them as follows: tumor-associated cyst, infectious cyst, ex-vacuo type cyst, and congenital/developmental cyst. RESULTS: Among 59 patients, 47 tumor-associated cysts were seen in 17, 42 infectious cysts in 13, 17 ex-vacuo type cysts in 10, and 19 congenital/developmental cysts in 19. In 44 of 47 tumor-associated cysts, increased or inhomogeneous internal signal intensity was seen on T1-weighted image, 37 of 47 showed thick uneven walls ; 35 of 47 had enhancing solid components and there was variable perifocal edema and mass effect. Infectious cysts were multiple (11 of 13). In cases of brain abscess, increased internal signal intensity on T1-weighted image, low signal intensity of abscess wall on T2-weighted image, thick even enhancing wall, and marked perifocal edema(4 of 4) were seen in all four cases. Cysts in cysticercosis were variable in appearance depending on the stage, but were smaller than other cystic lesions. Ex vacuo type cysts were of uniform CSF signal intensity in all pulse sequences and there was no identifiable wall or enhancement associated with enlarged adjacent ventricle and encephalomalacia(17 of 17). Congenital/developmental cysts showed a single lesion(19 of 19), a signal intensity similar to CSF in all pulse sequences(15 of 19), no identifiable wall(16 of 19), no enhancement(17 of 19), and no perifocal edema(19 of 19). CONCLUSION: MR was used to categorize supratentorial cystic intracranial lesions into four groups on the basis of their number, size, internal homogeneity of signal intensity on T1-weighted image, enhancing pattern, perifocal edema and mass effect, thereby improving diagnostic specificity and patient management.