ABSTRACT
INTRODUCTION: Cavernous hemangiomas or cavernomas are uncommon vascular malformations of the central nervous system involving most commonly the cerebral hemispheres where they are detected in young to middle aged adults. We present an unusual case of acute monoparesis caused by an intramedullary cavernoma in a woman of advanced age. CASE REPORT: A 67-year-old woman presented with walking difficulties with acute onset 2 months previously. On neurologic examination, there was a pure right leg monoparesis with moderate spasticity. Tendon reflexes were brisk and there was a Babinski's sign in her right lower limb. The initial diagnosis was lacunar stroke, but the brain magnetic resonance imaging revealed a right temporal cavernoma-obviously not associated with her monoparesis. The consequent spinal MRI revealed an intramedullary lesion at the T1 level, consistent with a cavernoma. CONCLUSION: Our patient presented with an acute monoparesis because of a spinal cavernoma, a most unusual occurrence.
Subject(s)
Hemangioma, Cavernous, Central Nervous System/complications , Medulla Oblongata , Paresis/etiology , Spinal Cord Diseases/complications , Acute Disease , Aged , Diagnosis, Differential , Female , Follow-Up Studies , Functional Laterality , Hemangioma, Cavernous, Central Nervous System/diagnosis , Hemangioma, Cavernous, Central Nervous System/pathology , Humans , Magnetic Resonance Imaging , Medulla Oblongata/pathology , Neurologic Examination , Paresis/diagnosis , Spinal Cord Diseases/diagnosis , Spinal Cord Diseases/pathology , Stroke/diagnosisABSTRACT
We describe a 57-year old female with the diagnosis of skull and meningeal Langerhans' cell histiocytosis who was treated with the combination of azathioprine and methotrexate. Although the skull lesions improved considerably on this regimen, the patient developed diabetes insipidus while the anterior pituitary function remained intact.
ABSTRACT
We report the unusual case of a 54-year-old man with a right atrial mass (detected by two-dimensional echocardiography) associated with hepatocellular carcinoma. The cardiac mass, following magnetic resonance imaging of the heart, was proved to be due to a direct extension of the liver tumour, via the inferior vena cava, up to the right atrial cavity. We wish to stress that the availability of magnetic resonance imaging renders possible the antemortem diagnosis of cardiac metastasis due to malignant tumours.
