1/21. meningioma of the fourth ventricle presenting with intermittent behaviour disorders: a case report and review of the literature.Intraventricular meningiomas are rare, representing 0.5-5% of all intracranial meningiomas. They arise mostly within the lateral ventricles and more rarely in the third ventricle. Meningiomas of the fourth ventricle are exceptional. They are clearly defined as meningiomas arising from the choroid plexus and lying strictly within the fourth ventricle. We report a 76 year old male patient presenting with a 2-week history of headache and cognitive disorders with agitation and restlessness particularly exacerbated at night or when lying down. CT scan and MR imaging showed a contrast-enhancing lesion located purely within the whole fourth ventricle, with slight ventricular enlargement. At surgery, we totally removed a well-vascularised, greyish encapsulated mass attached to the choroid plexus. Pathological examination revealed a WHO grade I fibroblastic meningioma. We reviewed the literature concerning this unusual meningioma location.- - - - - - - - - - ranking = 1keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
2/21. Effect of acetazolamide on ocular hemodynamics in pseudotumor cerebri associated with inflammatory bowel disease.PURPOSE: To describe the hemodynamic effect of oral acetazolamide administration on ocular perfusion in a patient with pseudotumor cerebri associated with crohn disease. DESIGN: Interventional case report. methods: A 20-year-old woman with a 5-year history of crohn disease presented with a 2-week history of headache and blurred vision in both eyes. Ophthalmologic examination was normal. fluorescein angiography showed a profound delay in retinal and choroidal perfusion. Lumbar puncture showed an opening pressure of 320 mm water. Therapy was initiated with oral acetazolamide 750 mg per day. RESULTS: A subjective improvement of symptoms was noted over 4 days. Repeat fluorescein angiography showed resolution of the ocular perfusion deficit. No recurrent symptoms were noted 19 months after cessation of therapy. CONCLUSIONS: crohn disease may present with pseudotumor cerebri and severe ocular perfusion deficits that are reversible with oral acetazolamide therapy.- - - - - - - - - - ranking = 0.033031080016416keywords = choroid (Clic here for more details about this article) |
3/21. Broadening the clinical spectrum: unusual presentation of spontaneous cerebrospinal fluid hypovolemia. Case report.The syndrome of spontaneous intracranial hypotension is characterized by orthostatic headaches in conjunction with reduced cerebrospinal fluid (CSF) pressure or CSF volume, and characteristic magnetic resonance (MR) imaging findings. A 50-year-old man presented with a 1-year history of paroxysmal ataxia of gait and short attacks of blurred vision when he stood up from a recumbent position and began to walk. Orthostatic headache was not a feature of his clinical presentation. Magnetic resonance images of the brain revealed diffuse enhancement of the dura mater and hygromas over both cerebral convexities. Magnetic resonance images of the spine demonstrated dilated cervical epidural veins and dilation of the perimedullary veins. Radionuclide cisternography identified a CSF leakage that was localized to the T12-L1 level on subsequent myelograms and on computerized tomography scans obtained after the myelograms. An epidural blood patch was administered and visualized with tungsten powder. The patient's clinical symptoms and sites of disease on imaging completely resolved. The unusual clinical presentation in this case--paroxysmal ataxia of gait, lack of orthostatic headaches, and dilated epidural and perimedullary venous plexus--supports a recently noted broadening of both the clinical and imaging characteristics of spontaneous intracranial hypovolemia.- - - - - - - - - - ranking = 0.010854466636901keywords = plexus (Clic here for more details about this article) |
4/21. Ventricular arteriovenous malformation bleeding: a rare cause of headache in children. Case report.headache as a chief complaint is rare in the paediatric emergency room. Actually, very seldom cases secondary to life threatening conditions as non-traumatic subarachnoid haemorrhage have been reported. A child with severe headache and nuchal rigidity and no other abnormalities on the physical examination is reported. magnetic resonance angiography and cerebral angiography disclosed a ventricular arteriovenous malformation in the choroid plexus, supplied by the anterior choroidal artery, classified according to Spetzler grading system as grade 3 (deep venous drainage: 1; eloquence area: 0 and size: 2). The differences in the clinical presentations of the central nervous system arteriovenous malformation between children and adults are discussed.- - - - - - - - - - ranking = 0.53303108001642keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
5/21. Ruptured arteriovenous malformation and subarachnoid hemorrhage during emergent cesarean delivery: a case report.Cerebral arteriovenous malformations (AVMs) are formed from a vascular plexus of direct arterial-venous connections that progressively dilate, making them prone to rupture. They are frequently asymptomatic and often remain undiagnosed until they present with associated symptoms of headaches, seizures, neurological deficits, or hemorrhages. Occurrence of headache during pregnancy and labor is associated with several diverse etiologies, making definitive diagnosis extremely difficult. This case report describes the anesthetic management of a 31-year-old laboring patient who first complained of headache, then suffered an acute subarachnoid hemorrhage secondary to rupture of a previously undiagnosed AVM during emergent cesarean delivery.- - - - - - - - - - ranking = 0.010854466636901keywords = plexus (Clic here for more details about this article) |
6/21. Ocular compression maneuver aborts benign cough-induced headache.Benign cough-induced headache is a short-lasting cranial discomfort. The therapeutic role of lumbar puncture (LP) or indomethacin in benign patients with benign cough-induced headache patients is debatable. Transient ocular compression (OC) raises intraocular pressure (IOP) and can limit the impact of cough-induced choroidal venous congestion. A self-applied maneuver that instantaneously aborts cough-induced headache is described in two patients. The effect of this maneuver supports a recent hypothesis that cough-induced headache may be due to ocular choroidal venous congestion and mechanical antidromic trigeminal nerve activation. The OC maneuver has several potential complications and its self-application in benign cough-induced headache should be regarded as an experimental procedure until more data regarding its efficacy and safety become available.- - - - - - - - - - ranking = 0.066062160032833keywords = choroid (Clic here for more details about this article) |
7/21. meningitis-retention syndrome. An unrecognized clinical condition.BACKGROUND: A combination of acute urinary retention and aseptic meningitis has not been well known. This combination can be referred to as meningitis-retention syndrome (MRS), when accompanied by no other abnormalities. OBJECTIVE: To describe the results of a uro-neurological assessment in our patients with MRS. methods: In three patients (two men, one woman; age, 34-68 years), we performed urodynamic studies and relevant imaging and neurophysiological tests, in addition to cerebrospinal fluid (CSF) examination. RESULTS: All three patients developed acute urinary retention along with headache, fever and stiff neck.None had obvious neurological abnormalities, other than a slightly brisk reflex in the lower extremities. One had previously experienced generalized erythematous eruptions, but none had pain, hypalgesia or skin eruptions in the sacral dermatomes suggestive of Elsberg syndrome (infectious sacral polyradiculitis; mostly genital herpes). brain/spinal/lumbar plexus MRI scans and nerve conduction studies were normal. CSF examination showed mild mononuclear pleocytosis, increased protein content, and normal to mildly decreased glucose content in all patients; increased myelin basic protein suggestive of central nervous system demyelination in one; and increased viral titers in none.Urodynamic study revealed, during the voiding phase, an underactive detrusor in all patients and an unrelaxing sphincter in one. These clinical manifestations were ameliorated within 3 weeks. CONCLUSIONS: We reported three cases of MRS, a peculiar syndrome that could be regarded as a mild variant of acute disseminated encephalomyelitis (ADEM). urinary retention might reflect acute shock phase of this disorder. Although MRS has a benign and self-remitting course, management of the acute urinary retention is necessary.- - - - - - - - - - ranking = 0.010854466636901keywords = plexus (Clic here for more details about this article) |
8/21. Pineal cyst apoplexy: case report and review of the literature.OBJECTIVE AND IMPORTANCE: Although most pineal cysts are clinically benign and asymptomatic, some can become symptomatic. Of the various symptomatic presentations, apoplexy is the rarest and most ill-defined. A comprehensive search of publications in the English language yielded 18 cases of pineal cyst apoplexy. We reviewed the literature to compare symptomatology and management strategies and their outcomes. CLINICAL PRESENTATION: A 29-year-old woman with a 1-month history of headaches presented with an acute worsening of her symptoms with a severe occipital headache and trouble focusing when reading. Her neurological examination was otherwise normal. magnetic resonance imaging showed pineal cyst apoplexy and accompanying hydrocephalus. INTERVENTION: A left paramedian craniotomy with a transcallosal, transchoroidal approach using an intraoperative neuronavigation system was used to resect a pineal cyst. Postoperative imaging showed complete removal of the cyst and resolution of the hydrocephalus. Follow-up imaging at 12 months demonstrated no evidence of recurrence or any hydrocephalus. The patient has remained asymptomatic for 18 months. CONCLUSION: Pineal cyst apoplexy should always be considered when following a patient with a pineal cyst that becomes symptomatic. The most common symptom was severe headache of sudden onset or acute worsening. Other signs of hydrocephalus may or may not be present. magnetic resonance imaging is essential to making a diagnosis. Although we believe that surgical resection is the most effective approach because it minimizes the risk for recurrence and complication, stereotactic aspiration has been used successfully to treat this condition.- - - - - - - - - - ranking = 0.033031080016416keywords = choroid (Clic here for more details about this article) |
9/21. Epidermoid tumour of the lateral ventricle.Epidermoids occurring within the lateral ventricles are rare. At one time, they were regarded as anatomical curiosities. The lesions are of developmental aetiology, due to migration of epiblast inclusion at the time of formation of the cerebral vesicle. They are slow growing, and presentation is non-specific in the form of deteriorating mental functions. Generally seen in the fifth decade, but they have also been observed in the paediatric age group. MRI is suggestive of a cystic lesion, and is confirmed to be a typical epidermoid within the lateral ventricle at operation, often having a connection to the midline through the choroidal fissure. The cysts should be excised with no additional morbidity. Histopathology reveals typical stratified squamous epithelium.- - - - - - - - - - ranking = 0.033031080016416keywords = choroid (Clic here for more details about this article) |
10/21. Diffuse villous hyperplasia of choroid plexus.Diffuse villous hyperplasia of choroid plexus (DVHCP) is a rare condition which is characterized by the presence of diffuse enlargement of the entire choroid plexus throughout the length of the choroidal fissure and overproduction of CSF. The diagnosis of diffuse villous hyperplasia of choroid plexus can be established by the MR demonstration of diffusely large, contrast enhanced choroid plexus in the cases of overproduction hydrocephalus. Although some authors recommend choroid plexus excision or coagulation, ventriculo-atrial shunt insertion is a simple and effective treatment modality in cases of diffuse villous hyperplasia of the choroid plexus. In this report we present a case of diffuse villous hyperplasia of the choroid plexus and a short review of the literature. To our knowledge, in the CT and MRI era only 5 cases of DVHCP cases have been reported.- - - - - - - - - - ranking = 5.5330310800164keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
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