RESUMO
Neuromyelitis optica spectrum disorders (NMOSDs) usually manifest with features of long-segment myelitis and/or optic neuritis. Area postrema involvement presents with nausea, vomiting, and intractable hiccups. Cerebral cortical involvement is a relatively uncommon phenomenon. This report describes an interesting case of aquaporin 4 antibody positive NMOSD with extensive cerebral cortical involvement in addition to area postrema and cervicomedullary lesions observed on magnetic resonance imaging. Following immunosuppressive therapy, good clinical response and near-complete resolution of brain imaging abnormalities were observed.
RESUMO
Longitudinally extensive transverse myelitis (LETM) is described in neuromyelitis optica spectrum disorders. Simultaneous active pulmonary tuberculosis in these disorders is a relatively rare phenomenon. We report a 16 year-old boy diagnosed as LETM with clinicoradiological correlation. Further evaluation revealed active pulmonary tuberculosis. He had good recovery following the combination of antituberculosis regimen with corticosteroids.
Assuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Encéfalo/diagnóstico por imagem , Leucoencefalopatias/diagnóstico por imagem , Metotrexato/efeitos adversos , Adolescente , Antimetabólitos Antineoplásicos/uso terapêutico , Feminino , Humanos , Leucoencefalopatias/induzido quimicamente , Imageamento por Ressonância Magnética , Metotrexato/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológicoRESUMO
Subacute sclerosing panencephalitis (SSPE) is a rare, slowly progressing but invariably fatal disease that is related to a prior measles virus infection and most commonly affects paediatric patients. Magnetic resonance (MR) imaging is the modality of choice for determining such changes in white matter. SSPE typically demonstrates bilateral but asymmetric periventricular and subcortical white matter involvement. We herein report a rare case of unilateral white matter involvement in a 13-year-old boy with SSPE that closely simulated Rasmussen's encephalitis. To the best of our knowledge, this is the first report of an atypical presentation on MR imaging in which SSPE was a rare cause of unilateral brain parenchymal involvement in a patient with intractable seizures.
Assuntos
Diagnóstico Diferencial , Encefalite/diagnóstico , Panencefalite Esclerosante Subaguda/diagnóstico , Adolescente , Encéfalo/patologia , Encefalite/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Panencefalite Esclerosante Subaguda/patologiaRESUMO
Congenital duplication of facial nerve is a very rare anomaly commonly associated with inner and middle ear anomalies. There can be duplication of mastoid, tympanic, or labyrinthine segments. We describe duplication of mastoid segment of facial nerve in a young female who also showed middle ear anomalies and external auditory canal atresia.
Assuntos
Aneurisma/diagnóstico por imagem , Sequestro Broncopulmonar/diagnóstico por imagem , Artéria Pulmonar/anormalidades , Intensificação de Imagem Radiográfica , Malformações Vasculares/diagnóstico por imagem , Adulto , Aneurisma/cirurgia , Sequestro Broncopulmonar/cirurgia , Meios de Contraste , Tosse/diagnóstico por imagem , Tosse/etiologia , Hemoptise/diagnóstico por imagem , Hemoptise/etiologia , Humanos , Masculino , Artéria Pulmonar/diagnóstico por imagem , Radiografia Torácica/métodos , Doenças Raras , Medição de Risco , Índice de Gravidade de Doença , Toracotomia/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Malformações Vasculares/complicaçõesRESUMO
Hyperammonemic encephalopathy is a type of metabolic encephalopathy with diversified etiology. Hyperammonemia is the end result of several metabolic disorders such as congenital deficiencies of urea cycle enzymes, hepatic encephalopathy, Reye's syndrome and other toxic encephalopathies. Non-specific clinical presentation poses a great challenge in early diagnosis of this entity. Irrespective of the underlying etiology, hyperammonemia causes a distinctive pattern of brain parenchymal injury. The cingulate gyrus and insular cortex are more vulnerable to this type of toxic insult. Characteristic magnetic resonance imaging findings in combination with laboratory parameters can help to differentiate this entity from other metabolic encephalopathy and thus aiding in early diagnosis and treatment.
Assuntos
Encefalopatias/diagnóstico , Encefalopatias/etiologia , Hiperamonemia/diagnóstico , Hiperamonemia/etiologia , Hepatopatias/complicações , Gânglios da Base/patologia , Encefalopatias/complicações , Córtex Cerebral/patologia , Doença Crônica , Feminino , Seguimentos , Humanos , Hiperamonemia/complicações , Imageamento por Ressonância Magnética , Pessoa de Meia-IdadeRESUMO
Congenital distal tibiofibular synostosis is a very rare anomaly. The cases of congenital tibiofibular synostosis reported in the literature so far have been confined to the proximal tibiofibular joint. We present an unusual case of tibiofibular synostosis that involves the distal part of the tibia and fibula based on characteristic X-ray, CT, and MRI findings.
RESUMO
An uncommon case of idiopathic chondrolysis of the hip in an 11-year-old girl is reported. It was characterized by clinical presentation, laboratory tests, and imaging techniques. A differential diagnosis is discussed highlighting the radiological features for quick diagnosis.
Assuntos
Doenças das Cartilagens/diagnóstico , Cartilagem Articular/patologia , Articulação do Quadril/patologia , Biópsia , Doenças das Cartilagens/patologia , Criança , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância MagnéticaRESUMO
We describe MRI findings in a fatal case of culture proven Salmonella typhi-associated encephalopathy. MRI findings included symmetrical diffuse abnormal signal in centrum semiovale, periventricular and deep white matter, splenium of corpus callosum and cerebellar deep white matter with central area of restricted diffusion. There was no contrast enhancement, significant edema or mass effect. Previous literature is also reviewed for imaging findings in Salmonella associated encephalopathy.
Assuntos
Encéfalo/patologia , Encefalite/patologia , Salmonella typhi , Adolescente , Encefalite/microbiologia , Evolução Fatal , Feminino , Humanos , Imageamento por Ressonância MagnéticaRESUMO
Idiopathic hypoparathyroidism can rarely present with extensive spondyloarthropathic changes that closely resemble ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, or fluorosis. Clinical presentation of the patient, typical laboratory parameters, and radiological findings aid in their differential diagnosis. Extensive spondyloarthropathy with normal sacroiliac joints in patients with neuromuscular symptoms like tetany, paresthesia, and hypocalcemia should raise the possibility of this entity.