ABSTRACT
BACKGROUND: Isolated thrombosis of the deep cerebral veins is rare and its diagnosis can be difficult. Mortality is often high and little is known about the long-term prognosis. CASE REPORT: We report a 24-year-old woman with akinetic mutism and extensive bilateral thalamic lesions. CT and MRI allowed early diagnosis by demonstrating thrombosis within the internal cerebral veins, without the need for angiography. Heparin treatment was used safely despite the presence of thalamic and intraventricular hemorrhage. After five weeks, the patient recovered rapidly and remains well at 18 months. Serial MRI showed dramatic resolution of the imaging abnormalities. CONCLUSIONS: The clinical features and characteristic neuroimaging appearance of deep cerebral venous thrombosis should be recognized by physicians caring for stroke patients. Deep cerebral venous thrombosis can produce extensive venous congestion and vasogenic edema without early infarction. Excellent clinical recovery is possible even after severe and prolonged neurological deficits.
Subject(s)
Akinetic Mutism/pathology , Diencephalon/pathology , Intracranial Thrombosis/pathology , Venous Thrombosis/pathology , Adult , Akinetic Mutism/etiology , Female , Humans , Intracranial Thrombosis/complications , Magnetic Resonance Imaging , Prognosis , Recovery of Function , Venous Thrombosis/complicationsSubject(s)
Accidents, Traffic/psychology , Patient Care Team , Stress Disorders, Post-Traumatic/diagnosis , Accidents, Traffic/legislation & jurisprudence , Expert Testimony/legislation & jurisprudence , Humans , Insurance, Accident/legislation & jurisprudence , Patient Care Team/legislation & jurisprudence , Risk Factors , Stress Disorders, Post-Traumatic/psychologySubject(s)
Brain Neoplasms , Melanoma , Neoplasms, Multiple Primary , Nevus of Ota , Skin Neoplasms , Adult , Facial Neoplasms , Female , HumansABSTRACT
The pathophysiology of chorea in systemic lupus erythematosus (SLE) is uncertain. Pathologic examination has not identified a specific location for the causative lesion(s) and immunologic mechanisms have been suggested in its etiology. In other choreic disorders, such as Huntington's disease and benign hereditary chorea, glucose hypometabolism in the striatum has been demonstrated by positron computed tomography (PCT) using [18F]deoxyglucose. With this technique we have studied four patients with chorea secondary to SLE. In these patients the regional distribution of cerebral glucose metabolism was normal. In particular, striatal glucose metabolism was within the normal range, even though the ratio of striatal to cortical glucose metabolism was increased. Our results show that striatal hypometabolism, as seen in other disorders manifesting chorea, is not the PCT correlate of the dyskinesia.
Subject(s)
Blood Glucose/metabolism , Brain/physiopathology , Chorea/physiopathology , Lupus Erythematosus, Systemic/physiopathology , Tomography, Emission-Computed , Adult , Corpus Striatum/physiopathology , Deoxyglucose/analogs & derivatives , Female , Fluorodeoxyglucose F18 , Humans , Male , Pregnancy , Pregnancy Complications/physiopathology , Thalamus/physiopathologyABSTRACT
A 27-year-old woman presented with hemotomyelia during pregnancy. Needle drainage of the spinal cord was followed by relief of symptoms. Symptoms recurred during a second pregnancy 4 years later and she presented with an avascular mass in the midcervical spinal cord. This lesion proved to be hemangioma calcificans, a densely calcified and ossified variant of cavernous angioma.
Subject(s)
Hemangioma, Cavernous/pathology , Pregnancy Complications, Neoplastic/pathology , Spinal Cord Neoplasms/pathology , Adult , Calcinosis/pathology , Female , Humans , PregnancyABSTRACT
An elderly woman presented with a large, fungating mass over the occipital portion of the scalp. Biopsy revealed this to be a pilar tumor of the scalp. The tumor was excised with a margin of normal tissue and the defect was closed with advancement of scalp and neck skin. Follow-up at 6 months revealed no recurrence of the lesion.
