1/13. herpes simplex virus encephalitis simulating a frontoparietal convexity neoplasm.The unusual occurrence of a single, cell circumscribed encephalitis due to herpes simplex virus in the frontoparietal convexity is described and served to underline the importance of considering this pathology in the event of a rapidly expanding lesion presenting in any portion of the brain. The valuable, but limited, usefulness of brain scanning and cerebral angiography in making this diagnosis is discussed. Neurosurgical intervention and brain biopsy are required to make the definitive diagnosis.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/13. Transient enlargement of deep medullary veins in encephalitis.This case report concerns a woman who presented an atypical clinical pattern with some features of encephalitis and other features of brain tumor. cerebral angiography showed a unilateral cerebral mass with prominence of deep medullary veins, usually interpreted as evidence of a neoplasm. Brain biopsy was interpreted as astrocytoma. Subsequent spontaneous clinical remission and regression of angiographic findings led to a reappraisal of the microscopic interpretation with a final diagnosis of encephalitis. The pathogenesis of cerebral angiographic abnormalities observed with encephalitis is reviewed. The transient prominence of deep medullary veins is probably due to hyperemia. Followup angiography is recommended when encaphalitis is suspected.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
3/13. Spontaneous remission of a massive CNS inflammation with eosinophilic infiltrate.We report a case of spontaneous remission of a massive CNS lesion with eosinophilic infiltrate. This 69-year-old man had eosinophilia without any systemic disorder or laboratory evidence of the most common causes of hypereosinophilia. MRI of the brain suggested an infiltrating neoplasm, but histological examination of a needle biopsy specimen failed to show evidence of a neoplasm. Instead, the tissue demonstrated rarefaction and gliosis with striking perivascular and parenchymal infiltrates of eosinophils. The MRI abnormality and eosinophilia disappeared spontaneously. We speculate that eosinophil-derived neurotoxins might have been the cause of the transient CNS disorder observed in this patient.- - - - - - - - - - ranking = 0.5keywords = neoplasm (Clic here for more details about this article) |
4/13. Bilateral horizontal gaze palsy in presumed paraneoplastic brainstem encephalitis associated with a benign ovarian teratoma.A 28-year-old woman with a previous history of recurrent benign ovarian teratoma developed a bilateral horizontal gaze palsy, a right facial paresis, and bilateral trigeminal hypesthesia. magnetic resonance imaging disclosed high signal in the rostral pons. Results of all other laboratory studies, including those for antineuronal antibodies (anti-Hu, anti-Yo, anti-Ri, anti-Tr, anti-Ma1, anti-Ma2, and anti-CV2/CRMP5), were negative. Pelvic ultrasound revealed a residual mass in the left ovary, which was confirmed as teratoma on surgical pathological examination. Complete neurologic recovery occurred within two weeks of surgical removal of the teratoma and treatment with intravenous corticosteroids and immunoglobulin. This case demonstrates that a search for an occult neoplasm is extremely important in the diagnosis of presumed paraneoplastic encephalitis even if antineuronal antibodies are not found.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
5/13. Paraneoplastic acute diffuse encephalitis revealing Hodgkin's disease.Paraneoplastic neurological syndromes are associated with various cancers. Cerebellar and limbic paraneoplastic manifestations are known to be associated with Hodgkin's disease (HD), but reports of diffuse encephalitis associated with HD are very rare. We report a case of acute severe diffuse encephalitis revealing a HD. Clinical presentation, cerebro-spinal fluid modifications and magnetic resonance imagery data are described. The treatment associated specific chemotherapy and plasma exchange. The neurological status improved dramatically within the first days of treatment, with parallel neoplasm regression. This case stresses the fact that encephalopathy can be the first sign of an undiagnosed extra-cerebral neoplasm.- - - - - - - - - - ranking = 0.5keywords = neoplasm (Clic here for more details about this article) |
6/13. The neurological complications of cardiac transplantation.review of the neurological complications encountered in 83 patients who received cardiac homografts over a seven-year period leads to the following conclusions: (1) Neurological disorders are common in transplant recipients, occurring in over 50 per cent of patients. (2) Infection was the single most frequent cause of the neurological dysfunction, being responsible for one-third of all CNS complications. (3) The infective organisms were typically those considered to be usually of low pathogenicity: fungi, viruses, protozoa and an uncommon bacterial strain. (4) Other clinical neurological syndromes were related to vascular lesions, often apparently from cerebral ischaemia or infarction occurring during the surgical procedure, metabolic encephalopathies, cerebral microglioma, acute psychotic episodes and back pain from vertebral compression fractures. (5) The infectious complications and probably the development of neoplasms de novo, are related to immunosuppressive therapy which impairs virtually all host defence mechanisms and alters the nature of the host's response to infective agents or other foreign antigens. (6) Because neurological symptoms and signs were usually those of behavioural changes or deterioration in intellectual performance, the neurological examination was often of little value in diagnosing the nature or even the anatomical site of the neuropathological process. (7) The possibility of an infectious origin of the neurological manifestations must be aggressively pursued even in the absence of fever and a significantly abnormal spinal fluid examination. The diagnostic error made most frequently was to ascribe neurological symptoms erroneously to metabolic disturbances or to "intensive care unit psychosis" when they were in fact due to unrecognized CNS infection. (8) maintenance of mean cardiopulmonary bypass pressures above 70 mmHg, particularly in patients with known arteriosclerosis, may reduce operative morbidity. (9) Though increased diagnostic accuracy is possible with routine use of a variety of radiological and laboratory techniques, two further requirements probably must be met before a significant reduction in the frequency of neurological complications will occur: the advent of greater immunospecificity in suppressing rejection of the grafted organ while preserving defences against infection; and a more effective armamentarium of antiviral and antifungal drugs.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
7/13. Human immunodeficiency virus (HIV) leukoencephalopathy and the microcirculation.We studied the brains of three patients with acquired immune deficiency syndrome (AIDS), all of whom developed subacutely progressive dementia unassociated with opportunistic infection or neoplasm in the central nervous system. Computed tomographic (CT) scans of the head revealed cortical atrophy, ventricular dilation, and diffuse hypodensity of the centrum semiovale. On microscopic examination, the cerebral and cerebellar white matter in all cases showed diffuse and focal, angiocentric regions of myelin pallor, focal vacuolization, and extensive gliosis. Variable axonal loss and axonal spheroids were evident. The microvasculature showed striking changes, including mural thickening, increased cellularity, and enlargement and pleomorphism of endothelial cells with variable numbers of macrophages and multinucleated giant cells (MNGC), which often contained hemosiderin pigment. Human immunodeficiency virus type 1 (hiv-1) antigens were identified immunocytochemically within perivascular macrophages and MNGC and in some microglial cells. We suggest that the morphologic abnormalities of the microcirculation may be associated with an alteration of the blood-brain barrier. The increased vascular permeability could contribute to damage and loss of the white matter including both myelin and axons, and result in subcortical cerebral atrophy. The hiv-1 infected cells present in relation to the microvasculature may play a role in mediating the vascular injury.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
8/13. Paraneoplastic limbic encephalopathy with testicular carcinoma. A reversible neurologic syndrome.limbic encephalitis (encephalopathy) is a rare paraneoplastic syndrome which rarely responds to antineoplastic therapy. The authors report the first case of limbic encephalopathy associated with testicular carcinoma and the first histologically confirmed encephalopathy which responded to antineoplastic therapy of the associated neoplasm. The clinical and pathologic characteristics of paraneoplastic encephalopathies are discussed along with the potential for reversal of the neurologic process with effective antitumor therapy.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
9/13. The neurological features of early and 'latent' human immunodeficiency virus infection.Neurological manifestations of unknown cause occurring in patients who become or are HIV antibody positive with presumed normal immune function have been described recently. This report adds a further six cases, all of whom had normal CD4 cell counts either throughout the period of observation or after the episode of seroconversion. Three had an acute presentation, two in the context of documented seroconversion consisting of one of the following: an encephalitis, an ataxia, and confusion with neuralgic amyotrophy. Three had a subacute disorder occurring at a later phase of HIV infection but before opportunistic infections or neoplasms, and marked by a static mild cognitive deficit. This report extends the range of abnormalities that may be seen at seroconversion and documents the presence of a non-progressive cognitive deficit occurring in the latent phase of HIV infection.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
10/13. Herpes encephalitis and herpetic corneal disease.A case of herpes encephalitis is reported in a patient who had cranial irradiation and high dose steroids for a cerebral neoplasm. Before radiotherapy the patient had had herpetic infections of the skin and eye.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
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