A 28-year-old woman presented with a rare primary epidural hemangioma without adjacent vertebral involvement manifesting as progressive paraparesis. Magnetic resonance imaging of the thoracic spine showed an epidural lesion at T4-5 space appearing as isointense on T 1 -weighted images with enhancement by contrast medium and hyperintense on T 2 -weighted images. The lesion was totally removed microsurgically. Histological examination revealed cavernous hemangioma. She made a complete recovery from her symptoms and has remained asymptomatic for 9 years.
Aspergillus pituitary abscess should be considered in the differential diagnosis of a pituitary mass. The correct diagnosis of pituitary aspergillosis can only be achieved by histopathological examination because clinical and radiological findings including MRI are not specific and culture results are obtained later. Immediately after the diagnosis, intensive antifungal therapy should be started for a successful treatment.
The exudation rate in chronic SDH is correlated with a higher clinical grade (Markwalder Grade 2 or 3), mixed-density CT appearance, and reaccumulation. Therefore, exudation from macrocapillaries in the outer membrane of chronic SDH probably plays an important role in the pathophysiology and the growth of chronic SDH.
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