). Palavras-Chave► neuroparacoccidioidomicose ► paracoccidioidomicose ► abscesso fúngico ResumoA paracoccidioidomicose é uma micose sistêmica, endêmica na América Latina, causada pelo fungo Paracoccidioides brasiliensis. O Brasil é o país com maior número de casos. A afecção do sistema nervoso central (SNC), condição potencialmente fatal, ocorre em torno de 12% dos casos. Identificam-se as seguintes formas de apresentação: meníngea, mais rara; meningoencefálica; e pseudotumoral, mais frequente. Os exames de imagem são fundamentais no auxilio diagnóstico, porém a identificação histológica do fungo é necessária para confirmação. O quadro clínico depende da localização no neuroeixo. Apresentamos o caso de um homem, trabalhador rural, com formações expansivas no SNC, compatíveis com paracoccidioidomicose. AbstractParacoccidioidomycosis is a systemic mycosis, endemic in Latin America, caused by the fungus Paracoccidioides brasiliensis. Brazil is the country with the highest number of cases. The affection of the central nervous system (CNS), a potentially fatal condition, occurs in 12% of cases. The following forms of presentation are identified: meningeal, unusual, meningoencephalitis and pseudotumoral the latter two being more frequent. Imaging tests are essential in diagnostic, but the histological identification of the fungus is required for confirmation of the pathology. The clinical picture depends on neuraxial location. We present a case report of a male rural worker, with expansive lesions in the CNS, compatible with paracoccidioidomycosis.
Olfactory groove schwannomas (OGSs) are rare benign tumors of the anterior skull base region. Considering the lack of Schwann cells in the optic and olfactory nerves, their origin remains enigmatic. Despite the precursor cell, total resection of the lesion is curative, as long as the histopathological features of the tumor are compatible with schwannoma. We report the case of a 32-year-old woman, addicted to crack, who was brought to the hospital presenting with cognitive dysfunction after being physically assaulted, whose neuroimaging revealed a large extra-axial mass in the subfrontal sagittal region. The presentation, immunohistochemical markers and histogenesis are discussed in the present study, along with a literature review.
Neurocysticercosis is the most common parasitic infection affecting the central nervous system, usually involving the brain parenchyma, intracranial subarachnoid space, or ventricular system. In rare cases, there is involvement of the spine (vertebral, epidural, subdural, arachnoid, or intramedullary). Even in endemic regions, this variant is rare, with an incidence below 5% of all patients. The diagnosis is made based on the symptoms, which can be very unspecific, imaging and CSF analysis, with biopsy as a possibility. Treatment is usually curative, but important deficits can develop, due to compression of the spinal cord or nerve roots, arachnoiditis, or meningitis. We present the case of a patient who developed this entity, with poor clinical scenario, and review the literature on the topic. Palavras-chave ResumoNeurocisticercose é a infecção parasitária mais comum afetando o sistema nervoso central, geralmente envolvendo o parênquima cerebral, espaço subaracnóide intracraniano ou sistema ventricular. Em raros casos, há envolvimento da coluna vertebral, espaços epidural e subdural, aracnoide, ou intramedular. Mesmo em áreas endêmicas, esta variante é rara, com incidência abaixo de 5% entre todos os pacientes. O diagnóstico é feito com base nos sintomas, que podem ser bastante inespecíficos, neuroimagem e análise do líquor, sendo a biópsia uma possibilidade. O tratamento geralmente é curativo, porém importantes déficits podem se desenvolver, devido à compressão da medula espinhal ou raízes nervosas, aracnoidite ou meningite. Relatamos o caso de um paciente que desenvolveu esta entidade, com sintomatologia escassa, e revisamos a literatura sobre este tópico.
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