ABSTRACT
Pseudotumoural hemicerebellitis is exceedingly rare. It may closely resemble a tumour either clinically or on imaging, and a high index of suspicion is required to avoid unnecessary surgical procedures. MRI is the most useful diagnostic tool, and reveals a swollen cerebellar hemisphere, hyperintense in T(2) weighted images. A pattern of predominantly pial contrast enhancement, absence of a well-defined mass and regression of the abnormalities in follow up examinations help to rule out malignancy. We report two cases of pseudotumoural cerebellitis (an 11-year-old girl and a 9-year-old boy) studied with CT and MRI.
Subject(s)
Cerebellar Diseases/diagnosis , Encephalitis/diagnosis , Cerebellar Neoplasms/diagnosis , Child , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Male , Tomography, X-Ray ComputedABSTRACT
Three new cases of human infection with Lagochilascaris minor are reported. All the patients were from the state of Pará (Brazil), living in rural areas or close to the forest. They were admitted to hospitals in the Federal District due to the presence of abscesses in the region of the neck, ear, mastoid process and, in two of them, to the involvement also of the central nervous system. Microscopic examination of tissue samples taken from the lesions showed sections of eggs and worms--in different evolutive stages--identified as Lagochilascaris minor. Larvae and adult worms obtained from existing fistulae proved also to be of the same species. The three patients were treated with anthelmintic drugs and surgical excision of the lesions, with good clinical results. In two of them, however, relapsing occurred, suggesting that the drugs do not destroy the worm eggs, in spite of the apparent healing of the lesions.
Subject(s)
Nematode Infections/pathology , Adolescent , Adult , Animals , Antinematodal Agents/administration & dosage , Brazil , Child , Combined Modality Therapy , Drug Therapy, Combination , Female , Humans , Nematoda/isolation & purification , Nematode Infections/drug therapy , Nematode Infections/parasitology , Nematode Infections/surgery , RecurrenceABSTRACT
Seven cases of compromised pituitary fossa at the conventional skull X-ray, who had the final diagnosis of giant aneurysm of the intracavernous portion of the carotid artery (6 cases) and one of the anterior communicating artery, are reported. The main findings were: headache (7/7), complex ophthalmoplegia involving the III, IV and VI cranial nerves (5/7), compromised V cranial nerve (4/7) and eyeball pain (4/7). Other manifestations were: meningeal signs (2/7), unilateral blindness (1/7), hemiparesis (1/7), cacosmia (1/7) and inferior bitemporal quadrantanopsia (1/7). Five patients with intracavernous carotid artery aneurysm showed benefits with progressive occlusion of the internal carotid artery at the cervical level. One died before surgery. The case with anterior communicating artery aneurysm improved after its surgical clipping. Our data, in accord with the literature, support the conclusion that the differential diagnosis of aneurysms in the parasellar region remains a very difficult task. The accurate final diagnosis requires cerebral angiography and the surgical treatment with progressive occlusion at the cervical portion of the internal carotid artery has a relatively low risk with promising results.
