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1.
Cureus ; 16(1): e51647, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38313997

ABSTRACT

Intraventricular meningiomas are uncommon neoplasms originating within the ventricular system of the brain, constituting a rare subset of central nervous system tumors. Their unique location poses diagnostic challenges, and understanding their clinical manifestations is imperative for effective management. We present the case of a 56-year-old female who sought medical attention due to persistent, severe headaches localized in the occipital region. Laboratory investigations demonstrated normal values for a complete blood count, electrolytes, and liver function tests. Magnetic resonance imaging revealed a well-defined mass in the left occipital horn of the lateral ventricle, indicative of an intraventricular meningioma. Surgical resection of the intraventricular meningioma resulted in the resolution of the patient's headaches. This case contributes valuable insights into the diagnostic challenges posed by intraventricular meningiomas.

2.
Radiol Case Rep ; 19(3): 1118-1121, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38259704

ABSTRACT

Internal carotid artery ectasia (ICAE) is a rare vascular abnormality characterized by dilation and tortuosity of the internal carotid artery (ICA) beyond normal limits. ICAE is typically asymptomatic but can manifest with symptoms such as headache and dizziness. The exact cause of ICAE remains uncertain, but both congenital and acquired factors, including trauma, have been implicated. A 35-year-old female presented to the Emergency Room with severe headache and dizziness following a traumatic injury. Neurological examination revealed no deficits. Computed tomography (CT) scan showed an elongated and prominent right supraclinoid internal carotid artery with mural wall calcification. Subsequent magnetic resonance imaging (MRI) confirmed the diagnosis of internal carotid artery ectasia (ICAE) without significant stenosis or malformation. The patient remained asymptomatic during follow-up visits. Proactive monitoring was advised to detect potential complications at an early stage. This case emphasizes the incidental detection of ICAE in a patient with post-traumatic headache. ICAE is a rare condition with an elusive etiology, and its management depends on factors such as symptom severity and associated risks. Conservative management is often recommended for asymptomatic cases.

3.
Am J Case Rep ; 25: e941990, 2024 Jan 21.
Article in English | MEDLINE | ID: mdl-38245829

ABSTRACT

BACKGROUND Arachnoid cysts and pilocytic astrocytomas are distinct intracranial entities with differing clinical presentations, origins, and management strategies. Arachnoid cysts are benign fluid-filled sacs associated with congenital or acquired causes, while pilocytic astrocytomas are low-grade brain tumors, primarily affecting pediatric and young adult populations, originating from astrocytes. However, diagnosing pilocytic astrocytomas can be challenging due to their radiological features, sometimes resembling more common intracranial lesions, such as arachnoid cysts. This case underscores the need for vigilance and a multidisciplinary approach when confronted with neuroimaging findings that diverge from typical patterns. CASE REPORT We present a case of a 3-year-old girl who presented with persistent headaches, vomiting, and difficulty walking. Initial radiological assessment suggested an arachnoid cyst, given the patient's symptoms and imaging characteristics. Subsequently, the patient underwent a craniotomy, with intraoperative findings revealing a cystic lesion without a solid mural nodule, which was excised completely. Postoperatively, histopathological examination confirmed a diagnosis of extra-axial pilocytic astrocytoma. The patient's symptoms resolved, and she was discharged without neurological deficits. CONCLUSIONS Diagnosing extra-axial pilocytic astrocytomas presents challenges, due to their radiological similarities with more common intracranial lesions, like arachnoid cysts. This case underscores the importance of histopathological examination to confirm the diagnosis accurately. Surgical resection remains the primary treatment for extra-axial pilocytic astrocytomas, often resulting in a favorable prognosis.


Subject(s)
Arachnoid Cysts , Astrocytoma , Brain Neoplasms , Child, Preschool , Female , Humans , Arachnoid Cysts/diagnostic imaging , Arachnoid Cysts/surgery , Astrocytoma/diagnostic imaging , Astrocytoma/surgery , Biopsy , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/surgery , Magnetic Resonance Imaging , Neuroimaging
4.
Cureus ; 15(11): e48705, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38094553

ABSTRACT

Introduction Thyroid cancer, one of the most frequently diagnosed endocrine malignancies, has witnessed a discernible global surge, predominantly among young adults. The etiological spectrum of thyroid cancer ranges from genetic mutations to environmental triggers. The early and precise detection of thyroid nodules (TNs) is crucial, given their latent potential for malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) is an evidence-based stratification tool designed to standardize the assessment of TNs. Within this system, nodules categorized as TI-RADS 3 present an intermediate risk of malignancy, thereby necessitating meticulous evaluation. The objective of this study is to investigate the rates of cancer within thyroid nodules classified as TI-RADS 3, to determine the accuracy and effectiveness of the TI-RADS classification system in predicting malignancy at this intermediate-risk level, and to improve the diagnostic process and management strategies for these nodules. Methods A retrospective study was carried out on patients diagnosed with TI-RADS-3 thyroid nodules at King Fahad Hospital, Al-Hufof, between January 2019 and May 2023. Data were extracted from electronic medical records and encompassed patient demographics, and clinical and pathological details. Statistical analyses were performed using SPSS software version 27.0.1 (IBM Corp., Armonk, NY) examining the relationship between clinical characteristics and biopsy outcomes. Results The study involved 162 participants, mostly females (82.1%), with a median age of 43 years. Thyroid nodule analysis revealed 92.0% benign and 8.0% malignant cases, with the most common nodule size ranging from 2 to 2.4 cm. No significant correlation was found between clinical characteristics and biopsy results, indicating neither age nor gender significantly predicts malignancy in thyroid nodules within this cohort. Conclusion The majority of TI-RADS 3 nodules at King Fahad Hospital were benign. Yet, relying solely on TI-RADS for clinical decisions is not advised. An integrated approach, encompassing TI-RADS gradings and other nodule features, is essential for balanced patient management between intervention and observation.

5.
Cureus ; 15(3): e36485, 2023 Mar.
Article in English | MEDLINE | ID: mdl-37090346

ABSTRACT

Sacrococcygeal masses encompass a diverse range of pathologies. Prenatal ultrasound facilitates early detection of congenital sacrococcygeal masses. We present the case of a newborn of a 22-year-old woman who was identified to have a sacrococcygeal mass by prenatal ultrasound that was initially diagnosed as sacrococcygeal teratoma. On examination after delivery, a large midline mass in the sacrococcygeal region was observed, which was globular in shape and had smooth, thin skin with bluish discoloration. Magnetic resonance imaging revealed a cystic lesion that protruded through a caudal sacral defect, consistent with a sacrococcygeal meningocele. The patient underwent surgical repair of the meningocele without any intraoperative complications and had preserved motor function in the lower extremities after the procedure. This case underscores the challenge of distinguishing sacrococcygeal teratoma from meningocele based on clinical presentation and prenatal ultrasound findings. An accurate preoperative diagnosis is essential for effective surgical planning.

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