Filter by keywords:



Filtering documents. Please wait...

1/14. Transthyretin amyloidosis and superficial siderosis of the CNS.

    OBJECTIVE: To describe a previously unreported clinical and radiologic presentation of hereditary transthyretin (TTR)-related amyloidosis. BACKGROUND: Unexplained cerebellar ataxia, pyramidal syndrome, and hearing loss are observed in some patients with TTR-related amyloidoses. methods: We performed clinical, radiologic, and pathologic examinations of three family members with TTR-related (Ala36Pro) amyloidosis. RESULTS: The patient was a 69-year-old woman with vitreal amyloid deposits, progressive sensorineural deafness, cerebellar ataxia, pyramidal syndrome, and recurrent transient neurologic symptoms. Cranial MRI showed symmetric thin rims of low signal intensity in T2- and T2*-weighted images in the cortex of the sylvian fissures, of the cerebellar hemispheres and vermis, and in the quadrigeminal plate consistent with superficial siderosis of the CNS. Her older daughter had vitreal amyloid deposits, acute brown-sequard syndrome at C4, acute sensorineural deafness, and recurrent transient neurologic symptoms. Cranial MRI at age 48 revealed a rim of low signal intensity in T2- and T2*-weighted images in the superior vermis folia and the right sylvian cortex. In addition, two small hemosiderin deposits were seen in the left parietal cortex. Lumbar puncture yielded colorless CSF with increased ferritin content and was followed by fourth ventricle hemorrhage. Cranial MRI 11 months later showed progression of brain hemosiderin deposits. The younger daughter had vitreal deposits, sensorimotor polyneuropathy, and acute sensorineural hearing but no evidence of siderosis on cranial MRI. She died at age 43 years of posterior fossa subarachnoid hemorrhage, and the neuropathologic examination showed amyloid deposition in the leptomeningeal spaces and vessels. CONCLUSION: Transthyretin-related amyloidosis may cause superficial siderosis of the CNS through subarachnoid bleeding related to meningovascular amyloid deposition.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

2/14. central nervous system complications in patients with diffuse histiocytic and undifferentiated lymphoma: leukemia revisited.

    Fifteen of 52 patients (29%) with diffuse histiocytic and undifferentiated pleomorphic lymphoma developed central nervous system (CNS) complications, primarily leptomeningeal lymphoma. Lumbar puncture with cerebrospinal fluid cytology was the most useful test for diagnosis, and for following the response to therapy. Leptomeningitis developed during all stages of the patients' clinical course: at time of diagnosis, during progression of systemic disease, and most importantly as the initial site of relapse within 7 mo of attaining a complete clinical remission. patients with bone marrow involvement are at high risk for the development of leptomeningeal lymphoma. Pathologic findings suggest that entry into the leptomeninges involves extension from the medullary bone marrow cavity along perforating vessels through dura into the arachnoid space. The leptomeningeal lymphoma has been successfully controlled in all patients receiving intensive central nervous system therapy consisting of a combination of intrathecal drug administration and radiotherapy. The high frequency of this syndrome and the success in its control suggest that a controlled trial of prophylactic CNS therapy be instituted in patients with these histologic types of non-Hodgkin's lymphomas.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

3/14. Cerebrospinal trypanosomiasis masquerading as pulmonary infectious disease in a 1-year-old boy.

    A 1-year-old boy with cerebrospinal trypanosomiasis presented with severe respiratory symptoms, hepatosplenomegaly and no neurological signs of trypanosomiasis. Agitation and high fever on the 2nd day in hospital prompted a lumbar puncture and trypanosomes were recovered from the cerebrospinal fluid.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

4/14. rotavirus and central nervous system symptoms: cause or contaminant? case reports and review.

    rotavirus is a common cause of severe gastroenteritis in children. In 2 patients with rotavirus gastroenteritis who developed encephalopathy, rotavirus rna was detected in the cerebrospinal fluid (CSF) by reverse transcription-polymerase chain reaction; in 1 patient, rotavirus rna was detected on 2 occasions 3 weeks apart. There are increasing reports of cases in which patients who have seizures after an episode of rotavirus diarrhea have evidence of rotavirus in their CSF. A search of 2 large hospital discharge databases suggested that seizures are noted as part of the discharge diagnosis in the records of, at most, <4% of patients with rotavirus diarrhea versus 7% of patients with bacterial diarrhea. Although evidence suggesting that rotavirus is a cause of central nervous system sequelae remains inconclusive, the 2 case reports presented in this study further illustrate a possible association. Further study is required to determine whether detection of rotavirus in CSF represents a true pathogen, CSF contamination that occurs at the time of lumbar puncture or in the laboratory, or carriage of rotavirus rna in trafficking lymphocytes.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

5/14. Proliferative kinetics of central nervous system (CNS) leukemia.

    The proliferative kinetics of the leukemic cells in the cerebrospinal fluid (CSF) were studied in three adults with CNS leukemia after 18 and 8 months while receiving an intensive treatment regimen. One (J.L.) had acute myeloblastic leukemia and developed CNS disease after 5 years' treatment with arabinosylcytosine and 6-thioguanine. All were in marrow remission at the time of study. G.H. had had no therapy for CNS disease, A.K. had had intrathecal methotrexate 2 months previously, and J.L. had recently completed radiotherapy (1900 R) to the head. An Ommaya reservoir was placed in a lateral ventricle and 3H-thymidine was injected into the resrvoir every 12 hours for 10 days; samples of cells were obtained by lumbar puncture periodically for autoradiography. In all patients the flash 3H-thymidine labeling index (LI) of the leukemic cells was less than 2% (determined in vitro) and the mitotic index less than 0.1%. After 10 days of 3H-thymidine injections in vivo, the LIs of the leukemic cells were 55%, 36%, and 21% in G.H., A.K., and J.L., respectively. These findings indicate that leukemic cells may proliferate very slowly in the CNS, and stress the difficulty of eradicating CNS leukemia with chemotherapeutic agents which are only active against proliferating cells.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

6/14. Miliary tuberculosis involving the central nervous system.

    A woman with chronic systemic lupus erythematosus (SLE) was treated with prednisone, and developed an acute febrile neuroinfection. The magnetic resonance images (MRI) showed miliary micronodular lesions distributed diffusely within the central nervous system and lungs. Lumbar puncture showed pleocytosis with predominance of polymorphonuclear leukocytes, hypoglycorrhachia, elevated proteins and smears positive for acid-fast bacilli. The diagnosis was confirmed by culture of mycobacterium tuberculosis in the cerebrospinal fluid and bronchial biopsy tissue. She was treated with ethambutol, rifampin, isoniazid and pyrazinamide. MRI taken one month later showed significant improvement, but leg weakness persisted. Epidemiologic research showed her uncle with cavitary tuberculosis as the source of infection. He was also treated with combined antituberculous chemotherapy.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

7/14. Neuro-Behcets/neuro-Sweets disease presents simultaneously with severe tonsillitis, and features mimicking bacterial meningitis with skin lesions.

    The patient was hospitalized due to rapidly undulant fever and sore throat. Empirical antibiotic therapy was started, however, headache also occurred. Lumbar puncture disclosed polynuclear leukocyte-predominant pleocytosis indicating that the patient suffered from bacterial meningitis. The antibiotics therapy was increased, however, consciousness became impaired and erythema multiforme-like skin lesions appeared. T2-weighted brain magnetic resonance imaging showed high signal intensity in the brainstem. HLA testing revealed B54 and Cw1. The patient presented futures of Behcets disease at the same time as those of Sweets syndrome and it was difficult to distinguish between the two diseases. Administration of prednisolone showed remarkable effect.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

8/14. Asymptomatic blastomycosis of the central nervous system with progression in patients given ketoconazole therapy: a report of two cases.

    ketoconazole (KTZ) has largely replaced amphotericin b as first-line therapy for blastomycosis. However, KTZ penetrates poorly into the central nervous system (CNS), and therapeutic failure may be caused by initially unrecognized CNS infection. Two patients (22% [2/9] of all culture-proven cases of blastomycosis at Grady Memorial Hospital, Atlanta, over 15 years) developed CNS blastomycosis while receiving KTZ. Neither initially had CNS symptoms; both had cutaneous and pulmonary disease that responded to KTZ. If KTZ or other fungistatic imidazoles are to continue as primary therapy for blastomycosis, studies are needed to improve the ability to identify patients likely to experience treatment failure or develop CNS disease. Possibly all patients with disseminated blastomycosis, even those without CNS symptoms, should have lumbar puncture and computed tomography of the head before therapy. Critical evaluation of their immune function also may be required before making a therapeutic decision to use KTZ or amphotericin b.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

9/14. Supracallosal interhemispheric arachnoid cyst: resolution after intracystic hemorrhage and infection.

    A case of a large, symptomatic, supracallosal interhemispheric arachnoid cyst is presented. Positive contrast-enhanced computed tomographic (CT) cystography after stereotactic puncture and aspiration demonstrated lack of communication between the cyst and the subarachnoid space or ventricular system. A cystoperitoneal shunt was successful in relieving the patient's symptoms for 5 years. A delayed shunt infection after gynecologic surgery necessitated removal of the shunt, and was complicated by asymptomatic intracystic hemorrhage. Thereafter, serial CT and magnetic resonance imaging scans showed eventual disappearance of the cyst.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

10/14. Diffuse form of primary leptomeningeal gliomatosis. Case report.

    Primary leptomeningeal gliomatosis is rare, and the diffuse form is even rarer with only three cases reported in the literature. A fourth case is described in this report. Computerized tomography (CT) findings showed hydrocephalus with enhancement of the cerebral cisterns, and analysis of cerebrospinal fluid obtained by lumbar puncture showed many atypical cells. Based on these findings, a diagnosis of leptomeningeal tumor was made. There was some improvement in neurological and CT findings following radiotherapy and chemotherapy.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)
| Next ->


Leave a message about 'Central Nervous System Diseases'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.