Liponeurocytoma: Rare Neoplasm of the Central Nervous System.

In this case report, we characterize an instance of diagnosis, treatment, characteristics, and outcomes of a patient with a liponeurocytoma, a rare WHO grade II brain tumor first described in 1978. This tumor has been described with a wide array of radiographic, microscopic, and histologic features, and there remains no consensus regarding the role of radiation therapy. Most patients have favorable outcomes after surgical resection. Here we present the case of a 46-year-old female who underwent suboccipital craniectomy for resection of a cerebellar mass, which was diagnosed as liponeurocytoma on final pathology. The patient experienced resolution of symptoms and is neurologically intact two years after resection of the tumor.

An Unusual Presentation of Creutzfeldt-Jakob Disease and an Example of How Hickam's Dictum and Ockham's Razor Can Both Be Right.

Patients can have more than one neurological problem, and sorting out acute from chronic disease can be challenging. The authors report a middle-aged patient who presented with ataxia, right hemiparesis, and abnormal nystagmus. Magnetic resonance imaging (MRI) showed a Chiari and an arachnoid cyst with brainstem compression that appeared to explain his abnormal examination. Shortly after admission, he was noted to have intermittent abnormal behavior and confusion. History from family revealed significant acute and chronic psychiatric problems that appeared to explain his abnormal mental status; this delayed the diagnosis of intermittent complex partial seizures. The multitude of various symptoms resulted in a delay of the final diagnosis of Creutzfeldt-Jakob disease (CJD), which in retrospect explained the entire new physical examination, seizures, and mental status changes.