Imaging of Central Nervous System Autoimmune, Paraneoplastic, and Neuro-rheumatologic Disorders

Wahed, Lama Abdel; Cho, Tracey A.

doi:10.1212/con.0000000000001244

Cited by 2 publications

(3 citation statements)

References 80 publications

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“…A comprehensive overview of paraneoplastic syndromes is beyond the scope of this review and can be found in other Continuum issues. 66,67 COMMENT This case illustrates how cardiac function can be affected in a patient with a brain tumor infiltrating the right insula. Lack of clinical improvement despite treatment with corticosteroids and no electrographic findings to suggest an epileptiform mechanism for the events led to selection of a cardiac pacemaker as the appropriate treatment in this case.…”

Section: Case 11-2mentioning

confidence: 98%

“…Although supportive treatment is similar regardless of the etiology, distinguishing between neurotoxicity from antineoplastic agents (eg, checkpoint inhibitors) and antibody-mediated conditions is key for appropriately choosing targeted therapies, which often comprise tumor-related treatment and immunosuppression. A comprehensive overview of paraneoplastic syndromes is beyond the scope of this review and can be found in other Continuum issues 66,67 …”

Section: Indirect Tumor-mediated Complicationsmentioning

confidence: 99%

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Neuro-oncologic Emergencies

Maciel,

Busl

2024

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE Neuro-oncologic emergencies have become more frequent as cancer remains one of the leading causes of death in the United States, second only to heart disease. This article highlights key aspects of epidemiology, diagnosis, and management of acute neurologic complications in primary central nervous system malignancies and systemic cancer, following three thematic classifications: (1) complications that are anatomically or intrinsically tumor-related, (2) complications that are tumor-mediated, and (3) complications that are treatment-related. LATEST DEVELOPMENTS The main driver of mortality in patients with brain metastasis is systemic disease progression; however, intracranial hypertension, treatment-resistant seizures, and overall decline due to increased intracranial burden of disease are the main factors underlying neurologic-related deaths. Advances in the understanding of tumor-specific characteristics can better inform risk stratification of neurologic complications. Following standardized grading and management algorithms for neurotoxic syndromes related to newer immunologic therapies is paramount to achieving favorable outcomes. ESSENTIAL POINTS Neuro-oncologic emergencies span the boundaries of subspecialties in neurology and require a broad understanding of neuroimmunology, neuronal hyperexcitability, CSF flow dynamics, intracranial compliance, and neuroanatomy.

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Section: Case 11-2mentioning

confidence: 98%

Section: Indirect Tumor-mediated Complicationsmentioning

confidence: 99%

Neuro-oncologic Emergencies

Maciel,

Busl

2024

CONTINUUM: Lifelong Learning in Neurology

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“…It may appear serpentine as it follows the sulci where it must be carefully distinguished from blood vessels which also appear hyperintense when filled with contrast. Care should also be taken to look at the noncontrasted T1 sequence to distinguish from other causes of T1 hyperintense signal in the leptomeninges such as methemoglobin (subarachnoid hemorrhage) or melanin from metastatic melanoma [ 109 ••]. A pathognomonic finding in the spinal cord is the “Trident Sign” with a characteristic dorsal subpial pattern of enhancement [ 110 ].…”

Section: Neuroimaging Findingsmentioning

confidence: 99%

Neurosarcoidosis: Diagnostic Challenges and Mimics A Review

Shen

Lackey

Shah

2023

Curr Allergy Asthma Rep

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Purpose of Review Neurosarcoidosis is a rare manifestation of sarcoidosis that is challenging to diagnose. Biopsy confirmation of granulomas is not sufficient, as other granulomatous diseases can present similarly. This review is intended to guide the clinician in identifying key conditions to exclude prior to concluding a diagnosis of neurosarcoidosis. Recent Findings Although new biomarkers are being studied, there are no reliable tests for neurosarcoidosis. Advances in serum testing and imaging have improved the diagnosis for key mimics of neurosarcoidosis in certain clinical scenarios, but biopsy remains an important method of differentiation. Summary Key mimics of neurosarcoidosis in all cases include infections (tuberculosis, fungal), autoimmune disease (vasculitis, IgG4-related disease), and lymphoma. As neurosarcoidosis can affect any part of the nervous system, patients should have a unique differential diagnosis tailored to their clinical presentation. Although biopsy can assist with excluding mimics, diagnosis is ultimately clinical.

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Imaging of Central Nervous System Autoimmune, Paraneoplastic, and Neuro-rheumatologic Disorders

Cited by 2 publications

References 80 publications

Neuro-oncologic Emergencies

Neuro-oncologic Emergencies

Neurosarcoidosis: Diagnostic Challenges and Mimics A Review

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