ABSTRACT
Background: Pediatric sellar-suprasellar tuberculosis is a rare form of tuberculosis that affects the pituitary gland and surrounding areas in the brain. It can be difficult to diagnose based on clinical and radiological signs alone, as they can be similar to other pituitary masses. A combination of biological, hormonal, and imaging examinations can aid in making an accurate diagnosis. It is important to consider tuberculosis in the differential diagnosis of sellar-suprasellar masses in the pediatric population, especially in areas with a high prevalence of tuberculosis. Case Description: A 17-year-old male with no history of illness showed up with a series of symptoms, including headaches and vision problems. A sellar-suprasellar lesion was seen on imaging, along with several minor lesions. The diagnosis of tuberculosis meningitis with cerebral and pituitary tuberculoma was made after cerebrospinal fluid analysis revealed the presence of tuberculosis. Treatment with anti-tuberculosis drugs led to clinical improvement and lesion resolution. Conclusion: Children's sellar tuberculomas can be difficult to diagnose since they resemble other pituitary tumors. It is essential to take them into account in the differential diagnosis, especially in regions with a high incidence of tuberculosis. Long-term chemotherapy is the recommended course of treatment, and monthly follow-up visits are necessary to check hormone levels and evaluate whether a permanent hormone replacement is necessary.
ABSTRACT
Meningiomas are the most common extra-axial neoplasmof the central nervous system (CNS). There are a number of characteristic imaging features of meningiomas on magnetic resonance imaging (MRI) that allow an accurate diagnosis, however there are a number of atypical features that may be diagnostically challenging. Furthermore, a number of other neoplastic and non-neoplastic conditions may mimic meningiomas. This case highlights the importance of careful analysis of imaging findings and the need for consideration of all possible diagnoses, including rare or atypical presentations of common neoplasms such as meningiomas. Early detection and accurate diagnosis are crucial in determining the appropriate management and improving the outcomes for patients with intracranial tumors.
ABSTRACT
The bobble head doll syndrome is a rare neurological disorder characterized by repetitive and involuntary movement of the head that typically appear in childhood. It is usually associated with the dilatation of the third ventricle and one or more cystic lesions that can be treated surgically. We present the case of a 7-year-old girl with a history of autism, who has experiencing repetitive up and down head movements for 2 years, which were initially thought to be stereotypies. However, 2 months prior to admission, the movements worsened and were accompanied by symptoms of intracranial hypertension. The neurological examination revealed a coordination disorder, specifically a tremor, along with impairment of thermo-algic sensitivity. Ophthalmological examination was unremarkable, but the MRI indicated a colloid cyst of the third ventricle. A minimally invasive neuro-endoscopy procedure was chosen as the treatment of choice for our patient. The bobble head doll syndrome is a complex neurological disorder, and imaging is crucial in the diagnosis and treatment of any movement disorder to enable an early diagnosis and treatment.
ABSTRACT
Background: Vestibular schwannomas (VSs) are one of the most common tumors of the cerebellopontine angle and internal meatus, the evolution of this type of tumors is defined as unpredictable, it can enlarge or present a spontaneous regression as described in rare cases. Case Description: We report the case of a 50-year-old woman who presented with a large right full cystic VS revealed by a balance disorder associated with deafness in the right ear which spontaneously regressed. The patient was lost to follow-up for 3 years, the symptomatology improved, and the tumor clearly regressed without any surgical treatment. Conclusion: Spontaneous regression of solid-cystic VS is possible but rare, it can be part of conservative treatment, which requires regular follow-up.
ABSTRACT
The white cerebellum sign is a radiologic sign rarely described resulting from diffuse cerebral edema, reported especially in children with hypoxic brain lesions, it is usually associated with poor prognosis leading to irreversible brain damage. We report the case of a child who presented this sign after a severe head injury and differently from most of previous cases, our patient has recovered very successfully. The white cerebellum sign is a radiologic sign that is not frequently described, which when present carries a poor prognosis, one third of the patients die and the others have severe deficits, its identification is necessary for a better patient management.
