ABSTRACT
Tumors of the pineal region typically present with symptoms and signs of mass effect and increased intracranial pressure. However, although rare and can be overlooked, hearing impairment is a potential clinical finding in these cases. The authors describe a 24-year-old male who presented to the emergency room complaining of bilateral hearing impairment. Brain computed tomography showed a pineal region tumor. Histopathological examination demonstrated features consistent with germinoma. This case reports a rare presentation rarely seen in the literature and in practice as evident by the conducted literature review. Therefore, we highlight the importance of considering hearing impairment as a presenting symptom of pineal region tumors since prompt recognition and intervention, as demonstrated in this case, can lead to successful outcomes.
ABSTRACT
Remote cerebellar hemorrhage (RCH) is a rare complication following supratentorial craniotomies with unclear pathophysiology, predisposing factors, and clinical outcomes. This is a case of a 46-year-old female who presented to the emergency room with a complaint of severe headache associated with nausea. MRI studies demonstrated right frontal lesions consistent with low-grade glioma. She underwent a right frontal craniotomy, and the tumor was resected successfully. She developed a severe headache on postoperative day five, and CT scans showed ipsilateral cerebellar hematoma. She was managed conservatively and made a complete recovery within five days. Although rare, RCH requires prompt recognition, neurological monitoring, and management. Medical management and observation may be considered for patients without mass effect or acute hydrocephalus.
ABSTRACT
BACKGROUND: Rosai-Dorfman disease (RDD) is a rare pathologic entity caused by sinus histiocytosis with massive cervical lymphadenopathy. Isolated spinal involvement is an infrequent presentation of extranodal RDD. The clinical and radiologic appearance of RDD represents a diagnostic challenge. We report 2 patients with paraparesis caused by RDD of the thoracic spine and a PRISMA-style systematic review. CASE DESCRIPTION: There were 2 patients with isolated extranodal thoracic spinal RDD without cervical lymphadenopathy. One patient presented with anterior thoracic RDD and a subtotal resection. The small residual disease completely responded to the postoperative course of steroids. The second patient had extradural thoracic spine RDD, which was resected completely. A 6-month postoperative follow-up magnetic resonance imaging (MRI) scan showed local recurrence, which responded to radiation therapy. Five years follow-up of both patients showed normal neurologic functions and no recurrence on MRI scan surveillance. CONCLUSIONS: RDD is a rare occurrence and should be considered in the differential diagnosis of extradural or intradural spinal lesions. Gross total resection is recommended, and long-term clinical follow-up with MRI is advised. Residual or recurrent RDD requires steroids or radiation therapy.
