ABSTRACT
A 53-year-old woman with symptoms of hypopituitarism and ophthalmoplegia was diagnosed as having idiopathic granulomatous hypophysitis and later developed bilateral optic neuritis. She responded well to steroid treatment. Granulomatous hypophysitis is a rare entity, and this is the first reported case associated with optic neuritis.
Subject(s)
Granuloma/diagnosis , Meningitis/diagnosis , Optic Neuritis/diagnosis , Pituitary Diseases/diagnosis , Female , Glucocorticoids/therapeutic use , Granuloma/drug therapy , Humans , Hypopituitarism/diagnosis , Hypopituitarism/drug therapy , Magnetic Resonance Imaging , Meningitis/drug therapy , Methylprednisolone/therapeutic use , Middle Aged , Ophthalmoplegia/diagnosis , Ophthalmoplegia/drug therapy , Optic Neuritis/drug therapy , Pituitary Diseases/drug therapy , Visual AcuityABSTRACT
Twelve cases with circling seizures are presented with their clinical, electroencephalographic and radiological findings. Four patients had symptomatic partial epilepsy, five had cryptogenic partial epilepsy, and the remaining three had idiopathic generalized epilepsy. Three of the patients with symptomatic partial epilepsy had frontal lesion, and one had parito-occipital lesion. Turning direction had no lateralizing value in patients with partial epilepsy. Based on our study we conclude that circling seizures may occur in different epileptic syndromes and epilepsies. In cases with symptomatic partial epilepsy, lesions are mostly located in frontal lobes but also in parietooccipital areas.
Subject(s)
Epilepsies, Partial/diagnosis , Epilepsy, Generalized/diagnosis , Stereotyped Behavior/physiology , Adult , Astrocytoma/complications , Astrocytoma/diagnosis , Astrocytoma/physiopathology , Brain Neoplasms/complications , Brain Neoplasms/diagnosis , Brain Neoplasms/physiopathology , Cerebral Cortex/physiopathology , Diagnostic Imaging , Dominance, Cerebral/physiology , Electroencephalography , Epilepsies, Partial/etiology , Epilepsies, Partial/physiopathology , Epilepsy, Complex Partial/diagnosis , Epilepsy, Complex Partial/etiology , Epilepsy, Complex Partial/physiopathology , Epilepsy, Generalized/etiology , Epilepsy, Generalized/physiopathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Oligodendroglioma/complications , Oligodendroglioma/diagnosis , Oligodendroglioma/physiopathologyABSTRACT
Balo's concentric sclerosis was diagnosed antemortem in 2 patients, by magnetic resonance (MR) imaging showing striking concentric alternating rings in 1 patient and by characteristic histopathological features in the other. The course of the lesions and the concentric pattern were followed by MR imaging for 3 years and 18 months, respectively. One patient demonstrated spontaneous remission that has not been reported in Balo's disease. Balo's disease may not have a fulminant course as described in the past and the MR appearance of the chronic lesion may resemble that of a chronic multiple sclerosis plaque.
Subject(s)
Diffuse Cerebral Sclerosis of Schilder/diagnosis , Magnetic Resonance Imaging , Adult , Brain Diseases/diagnosis , Brain Diseases/pathology , Contrast Media , Diffuse Cerebral Sclerosis of Schilder/pathology , Female , Follow-Up Studies , Gadolinium , Gadolinium DTPA , Humans , Image Enhancement , Multiple Sclerosis/diagnosis , Multiple Sclerosis/pathology , Organometallic Compounds , Pentetic Acid/analogs & derivatives , Remission, SpontaneousABSTRACT
Somatic inhibitory seizures and amnesic seizures are thought to occur rarely. We describe a patient with both types of seizures who initially presented with a clinical picture of transient ischemic attack. Neuroradiological investigations revealed a lesion probably a cavernoma located above the parietooccipital sulcus in the isthmus of cingulate gyrus. Anticonvulsant therapy eliminated both types of seizure.
Subject(s)
Brain Neoplasms/complications , Hemangioma, Cavernous/complications , Neural Inhibition/physiology , Occipital Lobe/physiopathology , Paralysis/physiopathology , Parietal Lobe/physiopathology , Adult , Brain Neoplasms/physiopathology , Diagnosis, Differential , Electroencephalography , Gyrus Cinguli/physiopathology , Hemangioma, Cavernous/physiopathology , Humans , Ischemic Attack, Transient/etiology , Ischemic Attack, Transient/physiopathology , Magnetic Resonance Imaging , Male , Neurologic Examination , Paralysis/etiology , Tomography, X-Ray ComputedABSTRACT
The temporal lobe agenesis syndrome is a rare congenital abnormality. This syndrome frequently has been described in association with arachnoid cysts or abnormal collections of cerebrospinal fluid. Arachnoid cysts develop most frequently in the middle cranial fossa and almost all these cysts are unilateral. Bilateral middle cranial fossa arachnoid cysts are extremely rare and only 9 cases have been reported in the literature. We present an adult case with bilateral arachnoid cysts and temporal lobe agenesis whose mental examination and neurologic assessment is normal. The cysts are demonstrated by CT and metrizamid CT cysternography.
Subject(s)
Arachnoid Cysts/diagnosis , Brain Diseases/diagnosis , Adult , Arachnoid Cysts/diagnostic imaging , Brain Diseases/diagnostic imaging , Humans , Male , Metrizamide , Myelography , Temporal Lobe/abnormalities , Temporal Lobe/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
We present a case of hemiballismus related to cryptococcal meningitis. A 23 year-old man was hospitalized because of involuntary movements of his left side, confusion, hyperpyrexia, neck stiffness, bilateral papilledema, right hemiparesis and bilateral pyramidal signs. Diagnosis was made by CSF examination demonstrating cryptococci by india ink. CT with contrast showed hyperdense lesions in the head of the right caudate nucleus, in the left internal capsule and in the frontal and occipital lobes. After treatment with amphotericin B, 5-fluorocytosine and haloperidol, he experienced rapid recovery with disappearance of hemiballismus. To our knowledge, this is the first report of hemiballismus caused by cryptococcal meningitis.
Subject(s)
Cryptococcosis/complications , Meningitis/complications , Movement Disorders/etiology , Adult , Functional Laterality , Humans , Hypothalamus/microbiology , Hypothalamus/physiopathology , Male , Meningitis/microbiologyABSTRACT
We studied 33 consecutive patients with computed tomographic findings of decreased density in the periventricular white matter (leukoaraiosis). Computed tomograms in five (aged 56-75 years) of the 33 demonstrated intracerebral hematoma. The hemorrhages were situated in the thalamic area in four and in the parietotemporal area in one patient. These five patients were hypertensive and had signs characteristic of parenchymal hemorrhage. Three of the five patients had progressive dementia prior to the ictus, and two of the three also had a history of single or multiple strokes. There was no significant difference in the clinical findings of hematoma patients with or without leukoaraiosis.
Subject(s)
Cerebral Hemorrhage/complications , Demyelinating Diseases/complications , Hematoma/complications , Aged , Aged, 80 and over , Cerebral Hemorrhage/diagnostic imaging , Demyelinating Diseases/diagnostic imaging , Female , Hematoma/diagnostic imaging , Humans , Male , Middle Aged , Tomography, X-Ray ComputedSubject(s)
Brain Diseases/pathology , Mesencephalon , Tuberculoma/pathology , Adult , Brain Diseases/diagnostic imaging , Brain Diseases/physiopathology , Calcinosis/pathology , Humans , Male , Ossification, Heterotopic/pathology , Radiography , Tuberculoma/diagnostic imaging , Tuberculoma/physiopathologyABSTRACT
A review of computed tomograms (CT) of 7,120 patients demonstrated bilateral basal ganglia calcifications in 17. Skull roentgenograms were normal in all patients. Seven patients (41%) were older than 50 years of age with no basal ganglia dysfunction and metabolic abnormalities. Therefore it was thought that they may represent the senescent calcification. The second largest group was idiopathic hypoparathyroidism. These five patients (29%) were 16 to 32 years of age, had convulsive seizures and widespread calcifications. The other five patients had various symptomatology. Hypoparathyroidism should be investigated in young patients, if they have convulsive seizures and widespread basal ganglia calcifications on CT.
Subject(s)
Basal Ganglia Diseases/diagnostic imaging , Calcinosis/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Caudate Nucleus/diagnostic imaging , Cerebrovascular Disorders/diagnostic imaging , Child , Female , Globus Pallidus/diagnostic imaging , Humans , Hypoparathyroidism/diagnostic imaging , Male , Middle Aged , Putamen/diagnostic imagingABSTRACT
In a case of Wilson's disease with flapping tremor, computed tomography demonstrated bilateral low-density areas in the thalamocapsular regions. Computed tomographic findings in Wilson's disease are discussed.
