Abs tractBack grou nd: Brook e -Spie gl e r s yndrom e is a rare condition w ith a pre dis pos ition to de ve l op cutane ous adne xal ne opl as m s , e s pe cial l y cyl indrom as , trich oe pith e l iom as and s pirade nom as . M al ignant trans form ation of cyl indrom as is rare . In s uch cas e s us ual l y cyl indrocarcinom as de ve l op w ith in th e s e l e s ions . W e pres e nt an unus ual cas e of bas al ce l l carcinom a de ve l oping w ith in a pre e xis ting cyl indrom a.M ain ob se rvations: 58-ye ar-ol d w om an w ith a 30-ye ar h is tory of m ul tipl e de rm al cyl indrom as e xte ns ive l y invol ving h e r s cal p w as re fe rre d for de rm atol ogical tre atm e nt. Th e patie nt re porte d th at one of th e l ong-l as ting l e s ions , 5.5 cm in s ize , ul ce rate d w ith in th e fore going fe w w e e k s . H is topath ol ogy confirm e d cyl indrom as and bas al ce l l carcinom a w ith in th e ul ce rating tum or. Surgical e xcis ion of l arge s t cyl indrom a tum ors l e d to cos m e tic and functional im prove m e nt. M agne tic re s onance and com pute d tom ograph y s h ow e d tum or infil tration into th e s k ul l l am ina e xte rna. M e tas tas e s w e re e xcl ude d by ch e s t radiograph y and abdom inal ul tras ound e xam ination.Concl u sion: Patie nts w ith Brook e -Spie gl e r s yndrom e s h oul d be fol l ow e d-up for m al ignant trans form ation of s k in tum ors to pre ve nt de e p pe ne tration and pos s ibl e m e tas tas e s .Cyl indrom a trans form ing into bas al ce l l carcinom a in a patie nt w ith Brook e -Spie gl e r s yndrom e Back groundBrook e -Spie gl e r s yndrom e is a rare dis e as e w ith a predis pos ition to de ve l op num e rous cutane ous adne xal ne opl as m s s uch as cyl indrom as , trich oe pith e l iom as , s pirade nom as , trich obl as tom as , bas al ce l l carcinom as , foll icul ar cys ts and organoid ne vi. 1 M os t com m onl y th e s e l es ions de ve l op on th e h e ad and ne ck in m iddl e -age d and e l de rl y fe m al e s . D e ve l opm e nt of conjuction tum ors (i.e . s pirade nom a and cyl indrom a), carcinos arcom as and cyl indrocarcinom as as w e l l as concom itant pre s e nce of bas al ce l l carcinom as w as re porte d. 2,3,4,5 W e pre s e nt an unus ual cas e of bas al ce l l carcinom a deve l oping w ith in a pre e xis ting cyl indrom a in a patie nt w ith Brook e -Spie gl e r s yndrom e and re vie w curre nt l ite rature about ge ne tics and h is toge ne s is of th is dis e as e . Cas e Re portA 58-ye ar-ol d w om an w ith m ul tipl e tum ors e xte ns ive l y invol ving h e r s cal p w as re fe rre d for de rm atol ogic tre atm e nt. Sh e re porte d th at l e s ions h ave be e n appe aring and continuous l y grow ing for th e pas t 30 ye ars . Cl inical e xam ination re ve al e d num e rous firm , rubbe ry pink tum ors l ocate d on h e r s cal p and ne ck and s e ve ral nodul ar l e s ions on th e righ t ch e e k and th e uppe r back (Fig 1-5). Th e tum or of th e l e ft parie tal are a h ad be e n ul ce rating for s e veral w...
Many reports suggest the SARS-CoV-2 infection may result in neurological complications. A wide spectrum of clinical syndromes have been reported, including both central and peripheral nervous system. Such symptoms may be a consequence of a direct viral injury, secondary to systemic inflammatory response, autoimmune processes, ischemic lesions or combination of these. Anosmia and dysgeusia are highly prevalent in the early stage of infection. Cerebrovascular events in patients with COVID-19 have also been documented with increasing frequency. Some cases of parainfectious autoimmune neurologic manifestations concurrent with active SARS-CoV-2 infection have been described, including hemorrhagic necrotizing encephalopathy, Guillain-Barré and Miller-Fisher syndromes. There are also a few reports documenting encephalitis and acute demyelinating encephalomyelitis (ADEM) in the course of COVID-19. There is also a growing number of cases of patients after recovery from COVID-19 with psychosomatic disorders, manifesting with memory disfunction, cognitive functions disorders, depression or other affective disorders, which may lead to a decrease of intellectual functions. Many of these neurological manifestations of the infection are possible to distinguish using radiological imaging techniques. It plays a very important role in evaluating the course of COVID-19 as well as diagnosing respiratory complications and choosing a proper management of infected patients. Similarly, radiological techniques play crucial role in identifying the cause of neurological symptoms connected to SARS-CoV-2 infection, being one of the most important elements of diagnostics. Especially in case of the presence of nervous system implication, using radiological imaging techniques to monitor the emerging onset of various symptoms is crucial to assess the severity and scope of involvement. Quick diagnostic process and identifying complications as fast as possible in order to implement specific treatment can be crucial to avoid long-term secondary conditions and accelerate the recovery period. In this review, we present the most important neurological complications that may occur in the course of SARS-CoV-2 infection and summarize their radiological manifestations.
As a significant cause of intracerebral hemorrhages, seizures, and neurological decline, brain arteriovenous malformations (bAVMs) are a rare group of complex vascular lesions with devastating implications for patients’ quality of life. Although the concerted effort of the scientific community has improved our understanding of bAVM biology, the exact mechanism continues to be elucidated. Furthermore, to this day, due to the high heterogeneity of bAVMs as well as the lack of objective data brought by the lack of evaluative and comparative studies, there is no clear consensus on the treatment of this life-threatening and dynamic disease. As a consequence, patients often fall short of obtaining the optimal treatment. Endovascular embolization is an inherent part of multidisciplinary bAVM management that can be used in various clinical scenarios, each with different objectives. Well-trained neuro-interventional centers are proficient at curing bAVMs that are smaller than 3 cm; are located superficially in noneloquent areas; and have fewer, larger, and less tortuous feeding arteries. The transvenous approach is an emerging effective and safe technique that potentially offers a chance to cure previously untreatable bAVMs. This review provides the state of the art in all aspects of endovascular embolization in the management of bAVMs.
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