Cases reported "Brain Edema"

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1/31. A case of balamuthia mandrillaris meningoencephalitis.

    balamuthia mandrillaris is a newly described pathogen that causes granulomatous amebic encephalitis, an extremely rare clinical entity that usually occurs in immunosuppressed individuals. We report a case of pathologically proven Balamuthia encephalitis with unusual laboratory and radiologic findings. A 52-year-old woman with idiopathic seizures and a 2-year history of chronic neutropenia of unknown cause had a subacute illness with progressive lethargy, headaches, and coma and died 3 months after the onset of symptoms. Cerebrospinal fluid (CSF) glucose concentrations were extremely low or unmeasurable, a feature not previously described (to our knowledge). Cranial magnetic resonance imaging scans showed a single large temporal lobe nodule, followed 6 weeks later by the appearance of 18 ring-enhancing lesions in the cerebral hemispheres that disappeared after treatment with antibiotics and high-dose corticosteroids. The initial brain biopsy specimen and analysis of CSF samples did not demonstate amebae, but a second biopsy specimen and the postmortem pathologic examination showed Balamuthia trophozoites surrounded by widespread granulomatous inflammation and vasculitis. The patient's neutropenia and antibiotic use may have caused susceptibility to this organism. Amebic meningoencephalitis should be considered in cases of subacute meningoencephalitis with greatly depressed CSF glucose concentrations and multiple nodular lesions on cerebral imaging. Arch Neurol. 2000;57:1210-1212
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ranking = 1
keywords = encephalitis, meningoencephalitis
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2/31. mycoplasma pneumoniae infection, meningoencephalitis, and hemophagocytosis.

    central nervous system manifestations are a common extrapulmonary complication of mycoplasma pneumoniae infection, of which encephalitis is a well-recognized abnormality in children. In this report the first description of M. pneumoniae infection simultaneously complicated by meningoencephalitis and hemophagocytosis is presented.
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ranking = 0.76236585337044
keywords = encephalitis, meningoencephalitis
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3/31. Craniectomy in severe, life-threatening encephalitis: a report on outcome and long-term prognosis of four cases.

    OBJECTIVE: To report the feasibility of craniectomy with duraplasty in four patients with life-threatening encephalitis and, in particular, their long-term outcome. DESIGN: Report of four cases, analysis of the acute clinical course and neurological long-term sequelae. RESULTS: Generous craniectomy with duraplasty was performed in four patients with life-threatening encephalitis leading to decortication and decerebration. This treatment approach reduced intracranial pressure. The long-term sequelae (1.5-8 years after craniectomy) confirmed its appropriateness, having led to full neurological (cerebral) function, resocialization, and reintegration into their professional life in all four patients. CONCLUSION: Craniectomy with dural augmentation is a treatment approach in cases of severe space-occupying encephalitis, not only saving the patient's life but also leading to favorable long-term outcome.
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ranking = 0.74515853961039
keywords = encephalitis
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4/31. Long-time microdialysis in a patient with meningoencephalitis.

    As part of invasive neuromonitoring, long-time microdialysis was performed in a 32-year-old patient suffering from meningoencephalitis. Cerebral magnetic resonance imaging (MRI) revealed marked global brain oedema. An intracranial pressure (ICP) probe, brain tissue oxygen pressure measurement (pTiO(2)), and intraparenchymal microdialysis were used for intensive neuromonitoring. Despite high ICP, only intensive care therapy was applied for 16 days using deep propofol sedation, hyperventilation, and intermittent mannitol therapy. One year later, the condition of the patient was excellent. Intracerebral microdialysis with bedside measuring of lactate, pyruvate, glycerol, glucose, and glutamate is a useful additional tool for the monitoring of ICP management.
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ranking = 0.6559146334261
keywords = encephalitis, meningoencephalitis
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5/31. Vasogenic edema in Bickerstaff's brainstem encephalitis: a serial MRI study.

    The authors report serial MRI of a patient with Bickerstaff's brainstem encephalitis (BBE), disclosing caudal migration of an initial upper midbrain lesion. High apparent diffusion coefficient values imply a vasogenic rather than cytotoxic edema as the cause of the hyperintense signal changes on T2-weighted images.
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ranking = 0.53225609972171
keywords = encephalitis
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6/31. west nile virus encephalitis involving the substantia nigra: neuroimaging and pathologic findings with literature review.

    west nile virus has become a medically important arbovirus in the continental united states with its debut in 1999 in the new york city area. We present neuroimaging features and pathologic findings in 2 patients who were severely affected out of the more that 100 documented cases at our institution. Both patients showed striking involvement of the substantia nigra, a finding not previously reported for west nile virus.
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ranking = 0.42580487977737
keywords = encephalitis
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7/31. Cerebral mass lesion due to cytomegalovirus in a patient with AIDS: case report and literature review.

    cytomegalovirus (CMV) disease in acquired immunodeficiency syndrome (AIDS) patients most commonly presents as chorioretinitis and gastro-intestinal infection. Neurological involvement due to CMV may cause several clinical presentations: polyradiculitis, myelitis, encephalitis, ventriculo-encephalitis, and mononeuritis multiplex. Rarely, cerebral mass lesion is described. We report a 39 year-old woman with AIDS and previous cerebral toxoplasmosis. She presented with fever, seizures, and vulval ulcers. Her chest X-ray showed multiple lung nodules, and a large frontal lobe lesion was seen in a brain computed tomography scan. She underwent a brain biopsy through a frontal craniotomy, but her condition deteriorated and she died in the first postoperative day. Histopathological studies and immunohistochemistry disclosed CMV disease, and there was no evidence of cerebral toxoplasmosis, bacterial, mycobacterial or fungal infection. CMV disease should be considered in the differential diagnosis of cerebral mass lesion in AIDS patients. High suspicion index, timely diagnostic procedures (surgical or minimally invasive), and proper utilization of prophylactic and therapeutic medication could improve outcome of these patients.
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ranking = 0.21290243988868
keywords = encephalitis
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8/31. MR imaging in toxoplasmosis encephalitis after bone marrow transplantation: paucity of enhancement despite fulminant disease.

    We present a patient who underwent bone marrow transplantation (BMT) after developing chronic myelocytic leukemia. Four months after BMT, he became comatose and died. MR imaging revealed multifocal brain lesions that were progressive but produced no edema. Postcontrast studies revealed that most of the lesions were nonenhancing. There was only discrete, irregular leptomeningeal enhancement with possible minimal enhancement of the cortex and subcortical white matter. autopsy showed overwhelming toxoplasmosis encephalitis. This case illustrates that toxoplasmosis lesions may lack obvious contrast enhancement in the brain of the immunocompromised patients, despite severe involvement. Recognition of this unusual MR imaging manifestation of toxoplasmosis should lead to earlier diagnosis and treatment.
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ranking = 0.53225609972171
keywords = encephalitis
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9/31. naegleria fowleri hemorrhagic meningoencephalitis: report of two fatalities in children.

    Two cases of hemorrhagic meningoencephalitis secondary to naegleria fowleri infection confirmed by postmortem analysis are described. The first patient is a 5-year-old boy who presented with a severe headache, neck stiffness, and lethargy. His neurologic examination was significant for somnolence and nuchal rigidity. cerebrospinal fluid studies and structural neuroimaging were consistent with hemorrhagic meningoencephalitis. Another 5-year-old boy presented to a different institution 2 miles away in the same week with similar complaints. Both patients declined rapidly and expired within 48 hours of admission secondary to transtentorial herniation caused by the mass effect of inflammation, edema, and hemorrhage with displacement of the brain stem. Histopathologic and immunochemistry analysis of brain tissue revealed the presence of Naegleria trophozoites in both cases.
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ranking = 0.78709756011132
keywords = encephalitis, meningoencephalitis
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10/31. MRI and SPECT in influenzal encephalitis.

    Repeated magnetic resonance imaging studies were performed in a 22-month-old boy with influenzal encephalitis. T2-weighted magnetic resonance images disclosed multifocal hyperintense areas in the cortex and subcortical white matter of the left frontal, temporal, parietal, and right frontal lobes. 123I single photon emission computed tomography (SPECT) brain images demonstrated decreased uptake in the same regions. SPECT revealed larger areas of decreased uptake as compared with magnetic resonance imaging. One year after the onset of encephalitis, these brain lesions continue to be observed, although the patient has no apparent neurologic sequelae.
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ranking = 0.63870731966605
keywords = encephalitis
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