RESUMEN
We describe the case of a 41 year-old woman who presented with a slight slowness of the right hand movement, which began four months prior to admission. Neurological examination showed slight rest tremor of the right hand, moderate bradykinesia and rigidity. She had been taking medication for Parkinson's disease, but without any benefit. The patient underwent a gadolinium-enhanced brain MRI, which showed a large left sphenoid wing meningioma with surrounding edema compressing the basal ganglia. Total excision of tumor was performed. The right hemiparkinsonian signs were completely resolved. This rare case underlines the significance of neuroimaging in patients presenting with Parkinson's disease especially in those patients with a relatively younger age at onset or unresponsive to medication.
Asunto(s)
Neoplasias Meníngeas/complicaciones , Neoplasias Meníngeas/patología , Meningioma/complicaciones , Meningioma/patología , Enfermedad de Parkinson/etiología , Enfermedad de Parkinson/patología , Adulto , Edad de Inicio , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Enfermedad de Parkinson/diagnóstico , Tomografía Computarizada por Rayos X/métodosRESUMEN
Few reports of os odontoideum have been made. We report two cases where this affection was revealed by cervical pain and hemiparesis in one case and acute tetraparesis in the other. Patients with os odontoideum usually present with neurological signs, but some have only cervical pain and some others remain asymptomatic. Radiological exams, including radiograms, cervical scanner and MRI lead to the diagnosis. Different surgical treatment can be proposed to symptomatic patients. Prophylactic surgical treatment is not indicated.
Asunto(s)
Vértebras Cervicales/patología , Apófisis Odontoides/diagnóstico por imagen , Apófisis Odontoides/patología , Enfermedades de la Médula Espinal/patología , Adulto , Vértebras Cervicales/diagnóstico por imagen , Niño , Osículos del Oído/diagnóstico por imagen , Osículos del Oído/patología , Femenino , Humanos , Paresia/etiología , Radiografía , Enfermedades de la Médula Espinal/diagnóstico por imagenAsunto(s)
Aspergilosis/complicaciones , Enfermedades de los Nervios Craneales/etiología , Sinusitis del Etmoides/complicaciones , Nervio Oftálmico , Sinusitis del Esfenoides/complicaciones , Anciano , Aspergilosis/diagnóstico , Sinusitis del Etmoides/diagnóstico , Sinusitis del Etmoides/microbiología , Humanos , Masculino , Sinusitis del Esfenoides/diagnóstico , Sinusitis del Esfenoides/microbiologíaRESUMEN
Brown tumors are classic bony lesions of hyperparathyroidism. They usually occur in severe forms with osteolytic subperiosteal lesions. Facial bones are a rare localization: 2% of all cases. The aim of this study was to report a case of multiple craniofacial location of brown tumors and to discuss, within a review of the literature, the role of imagery in the diagnosis of this disease.
Asunto(s)
Adenoma/diagnóstico , Hiperparatiroidismo Primario/diagnóstico , Lipoma/diagnóstico por imagen , Neoplasias Maxilares/diagnóstico por imagen , Neoplasias Primarias Múltiples , Neoplasias de las Paratiroides/diagnóstico , Complicaciones Neoplásicas del Embarazo , Adenoma/diagnóstico por imagen , Adenoma/cirugía , Adulto , Biopsia , Femenino , Humanos , Hiperparatiroidismo Primario/sangre , Lipoma/etiología , Lipoma/patología , Maxilar/patología , Neoplasias Maxilares/etiología , Neoplasias Maxilares/patología , Hormona Paratiroidea/sangre , Neoplasias de las Paratiroides/diagnóstico por imagen , Neoplasias de las Paratiroides/cirugía , Embarazo , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
We report a case of Maffucci syndrome in a 24-year-old patient, diagnosed thanks to the data of the clinical examination, the imagery and the histology. The clinical, radiological and evolutionary aspects are discussed, as well as the various therapeutic means.
Asunto(s)
Encondromatosis/diagnóstico , Adulto , Femenino , HumanosAsunto(s)
Tuberculosis Osteoarticular/diagnóstico por imagen , Adulto , Biopsia , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/patología , Masculino , Huesos Pélvicos/diagnóstico por imagen , Huesos Pélvicos/patología , Tomografía Computarizada por Rayos X , Tuberculosis Osteoarticular/patología , Tuberculosis de la Columna Vertebral/diagnóstico por imagen , Tuberculosis de la Columna Vertebral/patologíaRESUMEN
INTRODUCTION: Solitary plasmocytoma is rarely located in the cranial vault. Usually observed, in elderly patients, occurrence during adolescence is extremely rare. We report the case of a 16-year-old patient presenting a cranial vault solitary plasmocytoma which revealed Kahler disease. CASE REPORT: A 16-year-old patient consulted for a frontal tumefaction becoming painful with diplopia. The cranio-encephalic radiography and the MRI showed a tumoral process involving cranial vault; biopsy revealed a solitary plasmocytoma. Search for multiple myeloma was negative. Six months later, a disease of Kahler was declared. CONCLUSION: Clinical and biological follow-up of cranial plasmocytoma is necessary, because progression to multiple myeloma is possible as in our observation. Imaging and particularly MRI are needed to specify the axial seat of the tumoral process and its relationship with the nervous and vascular structures.
Asunto(s)
Plasmacitoma/patología , Neoplasias Craneales/patología , Adolescente , Terapia Combinada , Diagnóstico Diferencial , Diplopía/diagnóstico , Diplopía/etiología , Humanos , Imagen por Resonancia Magnética , Masculino , Plasmacitoma/complicaciones , Plasmacitoma/terapia , Neoplasias Craneales/complicaciones , Neoplasias Craneales/terapiaRESUMEN
Tuberous sclerosis is a phakomatosis with central nervous system manifestations characterized by 4 lesions detectable on neuro-imaging: tubers, white matter abnormalities, subependymal nodules and subependymal astrocytomas. The first three are benign lesions composed of by identical cytological lesions varying only in size and location. At CT, enhancement of subependymal nodules is usually considered as evidence of transformation to subependymal giant cell astrocytoma. This latter poses the problem of its relative benignity: hydrocephalus source of morbidity or even mortality. From a series of 22 cases, the authors review the characteristics of these abnormalities.
Asunto(s)
Esclerosis Tuberosa/diagnóstico , Humanos , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
Hemangiopericytoma is an uncommon mesenchymal neoplasm that rarely affects the spinal canal. We report a case of thoracic epidural hemangiopericytoma in a 39-year-old man with symptoms of spinal cord compression studied by myelo-computed tomography (CT) and magnetic resonance imaging (MRI). Total resection was followed by complete recovery. Postoperative radiotherapy was performed. The clinical, radiological, and histological findings of epidural spinal hemangiopericytoma are reviewed in the light of relevant literature
Asunto(s)
Neoplasias Epidurales/patología , Hemangiopericitoma/patología , Adulto , Neoplasias Epidurales/complicaciones , Neoplasias Epidurales/diagnóstico por imagen , Neoplasias Epidurales/terapia , Hemangiopericitoma/complicaciones , Hemangiopericitoma/diagnóstico por imagen , Hemangiopericitoma/terapia , Humanos , Laminectomía , Imagen por Resonancia Magnética , Masculino , Mielografía , Compresión de la Médula Espinal/etiología , Vértebras Torácicas , Tomografía Computarizada por Rayos XRESUMEN
The authors report an unusual case of spinal tuberculosis involving the posterior arch of T12 without disk lesion in a 20-year-old woman presenting with posterior compression of the spinal cord. The diagnosis was suggested at CT and MR imaging and confirmed by histological study after surgical resection. CT provides good evaluation of the bony lesion and may suggest intraspinal extension. MRI is superior for evaluation of cord compression. The patient improved after surgical and medical treatment. The imaging features of this entity are reviewed.
Asunto(s)
Imagen por Resonancia Magnética , Osteítis/diagnóstico , Vértebras Torácicas , Tomografía Computarizada por Rayos X , Tuberculosis de la Columna Vertebral/diagnóstico , Adulto , Antituberculosos/uso terapéutico , Dolor de Espalda/microbiología , Biopsia , Terapia Combinada , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Osteítis/complicaciones , Osteítis/cirugía , Compresión de la Médula Espinal/microbiología , Tomografía Computarizada por Rayos X/métodos , Tuberculosis de la Columna Vertebral/complicaciones , Tuberculosis de la Columna Vertebral/cirugíaRESUMEN
Syphilitic spinal cord gumma Syphilitic gummas of the central nervous system are exceptional and are in general described in the brain. We report the case of a Brown-Sequard syndrome in a 25-year-old patient. The cervical myelography and the brain CT as well as the vertebro-occipital junction were normal. The diagnosis of multiple sclerosis was evoked and corticosteroid therapy was initiated. The patient experienced clinical improvement. Two years later, the patient was readmitted. Immunological reactions for syphilis were positive, in serum and CSF. Tests for HIV were negative. The MRI showed a cervical spinal cord process at the C3 level with adhesive spinal associated arachnoiditis. Penicillin therapy was started prior to surgery for the spinal process. The syphilitic nature was confirmed by pathology. To our knowledge, the MR appearance of a syphilitic gumma of the spinal cord has not been described previously in the scientific literature.
Asunto(s)
Imagen por Resonancia Magnética , Tabes Dorsal/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Factores de TiempoRESUMEN
Pott's disease is the most common form of bone and joint tuberculosis, notably in the thoracolumbar spine. The sub-occipital localization remains exceptional, raising a major risk of spinal instability and severe bulbo-medullary complications. We report 2 new cases of tuberculous spondylodiscitis at the cervico-occipital junction revealed by signs of spinal compression associated with torticolis and dysphagia. The diagnosis was provided by CT scan and MR imaging and was confirmed histologically on a transoral biopsy of the retropharyngeal abscess. The patients were successfully treated with antituberculosis drugs combined with external stabilization of the spine. The diagnostic aspects, notably the neuroradiological findings in this particular localization of Pott's disease are recalled.
Asunto(s)
Vértebras Cervicales/patología , Tuberculosis de la Columna Vertebral/patología , Adolescente , Niño , Femenino , Humanos , Imagen por Resonancia Magnética , Hueso OccipitalRESUMEN
We report a rare case of spinal cord compression caused by a primary extradural hydatid cyst revealed at MRI.
Asunto(s)
Equinococosis/complicaciones , Compresión de la Médula Espinal/parasitología , Niño , Equinococosis/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Compresión de la Médula Espinal/patologíaRESUMEN
We report a case of congenital dermoid cyst of the conus medullaris without associated dysraphic lesion treated surgically. An 18-year-old man had a one-year history of bladder sphincter disorders and more recent acute renal failure with urinary tract infection. The diagnosis of intramedullary tumor was provided by myelo CT and MRI confirmed by histology. At 10-month follow-up, the postoperative course was good.
Asunto(s)
Quiste Dermoide/diagnóstico , Neoplasias de la Médula Espinal/diagnóstico , Retención Urinaria/complicaciones , Adolescente , Enfermedad Crónica , Quiste Dermoide/etiología , Humanos , Región Lumbosacra , Imagen por Resonancia Magnética , Masculino , Neoplasias de la Médula Espinal/etiología , Tomografía Computarizada por Rayos XAsunto(s)
Vértebras Lumbares , Tuberculosis de la Columna Vertebral/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
Spinal tuberculosis is the most frequent skeletal involvement in tuberculosis. The purpose of this study was to demonstrate the importance of the MRI and the helicoidal CT scan in the diagnosis of spinal tuberculosis. A retrospective study was conducted in 23 patients with spinal tuberculosis. The methods of investigation were helicoidal CT scan in 15 patients and MRI in the other eight patients. In the all cases with helicoidal CT scan, the features of the spinal tuberculosis were seen as an anterior vertebral body destruction with a paraspinal or epidural extension in 12 cases and a sequestrum formation in 5 cases. The analysis with helicoidal CT scan showed a gibbous deformity in 5 cases, a disk space narrowing in 14 cases and evaluated the extension very well. The MR imaging features showed one case in an early stage without features on the plain radiographs, and detected 3 cases of intramedullary lesions. A disruption of the longitudinal posterior vertebral ligament was found in one case and skip lesions at the granulomatous stage in 2 cases. MRI is superior to CT scan even helicoidal CT at the early lesion stage, skip lesions and the ligamentous or medullary lesions. For other lesions (bone, disk, extension), the MRI and CT scan are the same with an advantage for CT scan in osseous lesions.
Asunto(s)
Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X/métodos , Tuberculosis de la Columna Vertebral/diagnóstico , Adulto , Anciano , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tuberculosis de la Columna Vertebral/diagnóstico por imagenRESUMEN
Osteochondroma is a cartilaginous tumor, the most common benign tumor of bone. It may involve solitary or multiple exostoses (or osteochondromatosis) usually in hereditary multiple exostosis. The authors report a case of 13-year-old girl with a family history of hereditary multiples exostoses who presented with bilateral sciatica and cauda equina compression. The MRI showed a tumor of the L1 vertebral body. After surgery, pathologic specimens revealed the lesion to be an osteochondroma. Involvement of the vertebral column has been estimated from 1.3 to 4%. Spinal cord compression is rare. CT provides the analysis of the components of the tumor and clearly demonstrates it's intracanalar extension. MRI is superior in visualizing spinal cord compression. The prognosis is favorable after a surgical decompression.
Asunto(s)
Exocitosis , Compresión de la Médula Espinal/diagnóstico , Columna Vertebral/patología , Adolescente , Femenino , Humanos , Imagen por Resonancia MagnéticaRESUMEN
Primary tumors of the skull are rare and are estimated approximately in about 2.4% of all bone primary tumors. Primary craniofacial osteosarcoma accounts for 2 to 9% of cases in published series. The pure cranial location are estimated in the range of 0.7 to 3%. Spreading lesions to the central nervous system is uncommon, in addition plain film features are misleading due to the lock of evidence of osseous involvement of the calvaria. CT scan is more sensitive to demonstrate bone lesion as well as brain extension. MRI depict the soft tissue components even more clearly. We report two cases of skull osteosarcoma in two female patients without any preexistent affection. The particularity of these observations is that the intracranial extension presented as the brain tumor.