Serial neuroradiological studies in focal cerebritis

Hatta, Satomi; Mochizuki, Hitoshi; Kuru, Yutaka; Miwa, Hideto; Kondo, T.; Mori, Hideo; Mizuno, Yoshifumi

doi:10.1007/bf00593261

Cited by 14 publications

(5 citation statements)

References 12 publications

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“…An alternative explanation for such mismatch may be due to the fact that DWI findings have been reported in pathology besides ischemic stroke. DWI abnormality has been documented in patients with fungal cerebritis which was a precursor to abscess formation [3,4,10]. However, these findings were rather extensive and non-subtle in their cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cryptococcus Meningoencephalitis With Severe Localizing Neurological Deficits Mimicking a Large Right Middle Cerebral Artery Infarct in a HIV Patient

Tahhan¹,

Haritounian²,

Duong³

et al. 2021

Cureus

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Immunocompromised patients with Cryptococcal meningoencephalitis can develop focal neurological signs and symptoms. Stroke and abscess are usually the leading etiologies. Definitively localized non-fluctuating deficits mimicking a large middle cerebral artery (MCA) infarct without corresponding MRI findings is rare. Localized lobar cerebritis may be the underlying etiology. Despite having many different kinds of sequences, a significant pathological process can still evade MRI's detection. Diffusion-weighted imaging (DWI) abnormality has also been seen in pathology other than ischemic stroke.

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Section: Discussionmentioning

confidence: 99%

“…DWI can be positive in other pathologies as well. In fungal infection, DWI abnormality can be seen in cerebritis that eventually developed into an abscess [3,4]. For a disease process to evade MRI's detection, its pathophysiology could be nonferromagnetic in nature.…”

Section: Introductionmentioning

confidence: 99%

Cryptococcus Meningoencephalitis With Severe Localizing Neurological Deficits Mimicking a Large Right Middle Cerebral Artery Infarct in a HIV Patient

Tahhan¹,

Haritounian²,

Duong³

et al. 2021

Cureus

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“…4, In a study of infectious complications of 1143 patients who underwent neurological intervention, a 7% infectious complication rate was noted, the most common of which was an infection of the bone fl ap. 1 Risk factors for the development of infectious complications after a procedure include the presence of cerebrospinal fl uid leak, advanced age, and multiple neurosurgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Abscess Mimicking Recurrent Pilocytic Astrocytoma: A Case Report

Devkota

Jha

2016

Nep J Neurosci

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Cerebellar abscess is a rare condition occurring more commonly in children and adolescents usually caused by otitis media. They can occur following trauma or surgery or from septic focus directly or hematologically. It is sometime hard to distinguish from other space occupying lesion clinically or by imaging modalities. We report a case of an eight year boy who had undergone craniotomy and excision of a pilocytic astrocytoma two years back and now presented with headache and preoperative diagnosis of recurrent pilocytic astrocytoma was made. But, to our surprise, the operative findings showed an abscess which was confirmed with histopathology. The final diagnosis of cerebellar abscess was made.Nepal Journal of Neuroscience 12:85-87, 2015

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“…The low-intensity signal on the T 2 -weighted images would indicate the early-cerebritis phase of abscess formation if it was the cause in this case. 34 Lesions associated with early cerebritis, which lasts only a few days, are not enhanced with contrast material, 35 which is a strong argument against the diagnosis of a pyogenic infection.…”

Section: Ifferential D Iagnosismentioning

confidence: 99%

Case 33-1995

Ronthal¹,

Vonsattel²

1995

N Engl J Med

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A 43-year-old right-handed paraplegic man was admitted to the hospital because of increasing confusion and aphasia, increasing fatigue, weight loss, and new decubitus ulcers.The patient had been well until four years earlier, when diplopia, ataxia, dysarthria, and lethargy developed. A lumbar puncture was performed (Table 1). A magnetic resonance imaging (MRI) scan of the brain ( Fig. 1) showed increased T 2 -weighted signal intensity in the pons, which extended into the midbrain, cerebellum, and posterior limb of the internal capsules, with swelling of those structures and slight ventricular enlargement; there was minimal enhancement with gadolinium. Corticosteroids were administered and led to improvement, and the patient returned to his work as a mortician. A second MRI scan revealed diminished swelling of the brain and a decrease in the T 2 -weighted hyperintensity in portions of the basis pontis, midbrain, and thalamus; there was no hydrocephalus.Forty-four months before admission the patient became paraplegic. Evaluation revealed no evidence of vasculitis or lymphoma. Treatment with corticosteroids was resumed, and treatment with azathioprine was begun, with brief improvement, followed by a relapse. The patient remained confined to a wheelchair, despite a regimen of azathioprine (400 mg daily) and corticosteroids administered intravenously every two weeks.During the next three years repeated examinations of the cerebrospinal fluid showed elevated protein levels and intermittent pleocytosis; no leukocyte surface markers or oligoclonal bands were detected. Additional MRI examinations disclosed less marked changes in the brain stem, but increased T 2 -weighted hyperintensity had developed in the corona radiata bilaterally, with extension into the para-atrial areas and progressive diffuse, punctate enhancement of white matter after the administration of gadolinium (Fig. 2).Fifteen months before admission a lumbar puncture yielded acellular cerebrospinal fluid with a normal protein level. The dose of azathioprine was tapered. The patient's condition was subsequently stable until eight months before admission, when he had two short episodes of altered consciousness related to falls, with right hemiparesis and aphasia. Serial computed tomographic *To convert the value for glucose to millimoles per liter, multiply by 0.05551. †No oligoclonal bands were detected. Table 1. Lumbar-Puncture Findings.

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Serial neuroradiological studies in focal cerebritis

Cited by 14 publications

References 12 publications

Cryptococcus Meningoencephalitis With Severe Localizing Neurological Deficits Mimicking a Large Right Middle Cerebral Artery Infarct in a HIV Patient

Cryptococcus Meningoencephalitis With Severe Localizing Neurological Deficits Mimicking a Large Right Middle Cerebral Artery Infarct in a HIV Patient

Cerebellar Abscess Mimicking Recurrent Pilocytic Astrocytoma: A Case Report

Case 33-1995

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