Lhermitte-Duclos disease (LDD) is a rare cerebellar lesion characterized by a hamartomatous lesion of the cerebellum. Mainly diagnosed by MRI, the clinical presentation is usually made of neurological symptoms. Modern neuroimaging techniques such as MRI have led to accurate diagnosis of this disease in both its preand post-operative periods. We present the case of a 68-year-old male with a past medical history of cardiac stenting and coronary artery disease who originally presented to the emergency department as a transfer for evaluation of possible obstructing hydrocephalus and left posterior inferior cerebellar artery (PICA) infarct. Based on the clinical presentation and imaging, the favored diagnosis of his left cerebellar abnormality was LDD rather than an unusual acute/subacute infarct or a metastatic lesion. The rapid progression of symptoms with rapidly progressive cytotoxic edema on serial CTs helped exclude LDD, which is nearly always more of a chronic process. The classic neuroimaging findings and clinical presentation of LDD are also discussed.
Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vasculopathy with no identifiable underlying cause. Clinical manifestations of the disease typically occur at the site of occurrence. Ocular manifestations of fibromuscular dysplasia are rare but can occur in the form of central or branched retinal artery occlusions, which can cause painless monocular vision loss. We present the case of a 71-year-old female patient with FMD presenting with worsening visual acuity due to suspected right branch retinal artery occlusion. Pathology and imaging findings were consistent with classic FMD, and given our initial concerns for this patient, the rare ocular manifestations of this disease are highlighted.
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