RESUMO
INTRODUCTION: The objective of this study was to evaluate the cortical thickness and the volume of deep gray matter structures, measured from 3D T1-weighted gradient echo imaging, and white matter integrity, by diffusion tensor imaging (DTI) in patients with typical absence epilepsy (AE). METHODS: Patients (n = 19) with typical childhood AE and juvenile AE, currently taking antiepileptic medication, were compared with control subjects (n = 19), matched for gender and age. 3D T1 magnetization-prepared rapid gradient echo-weighted imaging and DTI along 30 noncolinear directions were performed using a 1.5-T MR scanner. FreeSurfer was used to perform cortical volumetric reconstruction and segmentation of deep gray matter structures. For tract-based spatial statistics analysis of DTI, a white matter skeleton was created, along with a permutation-based inference with 5000 permutations. A threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The mean, radial, and axial diffusivities were also projected onto the mean FA skeleton. RESULTS: Patients with AE presented decreased FA and increased mean diffusivity and radial diffusivity values in the genu and the body of the corpus callosum and right anterior corona radiata, as well as decreased axial diffusivity in the left posterior thalamic radiation, inferior cerebellar peduncle, right cerebral peduncle, and right corticospinal tract. However, there were no significant differences in cortical thickness or deep gray matter structure volumes between patients with AE and controls. CONCLUSION: Abnormalities found in white matter integrity may help to better understand the pathophysiology of AE and optimize diagnosis and treatment strategies.
Assuntos
Imagem de Tensor de Difusão/métodos , Epilepsia Tipo Ausência/patologia , Substância Cinzenta/patologia , Substância Branca/patologia , Anisotropia , Estudos Transversais , Feminino , Humanos , Imageamento Tridimensional , Masculino , Adulto JovemRESUMO
BACKGROUND AND PURPOSE: Conventional MR imaging typically yields normal images of the brain or indicates lesions in areas of high aquaporin expression in patients with neuromyelitis optica. Diffusional kurtosis imaging was applied in patients with neuromyelitis optica to determine whether this technique could detect alterations in diffusion and diffusional kurtosis parameters in normal-appearing white matter and to explore the relationship between diffusional kurtosis imaging and DTI parameters. MATERIALS AND METHODS: Thirteen patients with neuromyelitis optica and 13 healthy controls underwent MR imaging of the brain with conventional and diffusional kurtosis imaging sequences. Tract-based spatial statistics and region-of-interest-based analyses were conducted to identify differences between patients with neuromyelitis optica and controls through conventional DTI and diffusional kurtosis imaging parameters. The parameters were correlated to determine the potential relationship between them. RESULTS: Compared with healthy controls, several diffusional kurtosis imaging and DTI parameters were altered in various fiber tracts of patients with neuromyelitis optica (P < .05). A significant decrease (P < .05) in radial kurtosis was observed in the corpus callosum and anterior corona radiata and left optic radiation. Differences (P < .1) in mean kurtosis were found in patients with neuromyelitis optica. We found a negative correlation between diffusional kurtosis imaging (radial kurtosis, axial kurtosis, mean kurtosis) and the corresponding DTI parameters (radial diffusivity, axial diffusivity, mean diffusivity). Positive correlations were found for radial kurtosis and mean kurtosis with fractional anisotropy. CONCLUSIONS: This study demonstrated differences in conventional diffusion and diffusional kurtosis parameters, especially radial kurtosis, in the normal-appearing white matter of patients with neuromyelitis optica compared with healthy controls. Larger studies of patients with neuromyelitis optica should be performed to assess the potential clinical impact of these findings.
Assuntos
Imagem de Tensor de Difusão/métodos , Neuromielite Óptica/diagnóstico , Substância Branca/patologia , Adolescente , Adulto , Anisotropia , Biometria , Corpo Caloso/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuromielite Óptica/patologia , Adulto JovemRESUMO
We report on four cases of fetal cervical tumor, comprising three lymphangiomas and one teratoma, evaluated by ultrasound and magnetic resonance imaging (MRI) between 26 and 37 weeks' gestation. The aim was to investigate the use of virtual bronchoscopy to evaluate fetal airway patency in each case. A three-dimensional (3D) model of the airway was created from overlapping image layers generated by MRI. The files obtained were manipulated using 3D modeling software, allowing the virtual positioning of observation cameras, adjustment of lighting parameters and creation of simulated 3D movies for analysis of a virtual path through the model. In all fetuses, fetal airway patency was clearly demonstrated by virtual bronchoscopy and this was confirmed postnatally. MRI with virtual bronchoscopy could become a useful tool for studying fetal airway patency in cases of cervical tumor.
Assuntos
Broncoscopia/métodos , Feto/patologia , Neoplasias de Cabeça e Pescoço/complicações , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Sistema Respiratório/patologia , Feminino , Doenças Fetais/patologia , Humanos , Linfangioma/complicações , Masculino , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Teratoma/complicaçõesRESUMO
The current standard of care for newly diagnosed cases of high-grade glioma is surgical resection followed by RT with concurrent chemotherapy. The most widely used criteria for assessing treatment response are based on a 2D measurement of the enhancing area on MR imaging known as the Macdonald Criteria. Recently, nontumoral increases (pseudoprogression) and decreases (pseudoresponse) in enhancement have been found, and these can confuse outcome evaluation. Here we review pseudoprogression and pseudoresponse and describe how better understanding of these phenomena can aid interpretation.
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Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/terapia , Encéfalo/patologia , Glioma/diagnóstico , Glioma/terapia , Imageamento por Ressonância Magnética/métodos , Progressão da Doença , Humanos , Prognóstico , Resultado do TratamentoRESUMO
OBJECTIVE: To generate physical fetal models using images obtained by three-dimensional ultrasonography (3DUS), magnetic resonance imaging (MRI) and computed tomography (CT) to guide additive manufacturing technology. METHODS: Images from 33 fetuses, including three sets of twins, were used. Fifteen fetuses were normal and evaluated only by 3DUS. Eighteen cases had abnormalities such as conjoined twins, tumors, aneuploidy, skeletal abnormalities, central nervous system abnormalities and facial or thoracic defects. Scans were performed using high-resolution 3DUS. In cases of abnormalities, MRI and CT were performed on the same day as 3DUS. The images obtained with 3DUS, CT or MRI were exported to a workstation in DICOM format. A single observer performed slice-by-slice manual segmentation using a digital high-definition screen. Software that converts medical images into numerical models was used to construct virtual 3D models, which were physically realized using additive manufacturing technologies. RESULTS: Physical models based on 3DUS, MRI and CT images either separately or combined were successfully generated. They were remarkably similar to the postnatal appearance of the aborted fetus or newborn baby, especially in cases with pathology. CONCLUSION: The use of 3DUS, MRI and CT may improve our understanding of fetal anatomical characteristics, and these technologies can be used for educational purposes and as a method for parents to visualize their unborn baby. The images can be segmented and applied separately or combined to construct 3D virtual and physical models.
Assuntos
Feto/anatomia & histologia , Processamento de Imagem Assistida por Computador/métodos , Modelos Anatômicos , Feminino , Humanos , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Gravidez , Tomografia Computadorizada por Raios X/métodosRESUMO
Cervical synovial cysts are rare entities that are, most of the time, asymptomatic. They can cause nerve root or spinal cord compression, especially when acute haemorrhage or a marked increase in size occurs. Isolated unilateral hypoglossal nerve paralysis caused by compression of its cisternal segment is also an extremely rare condition. We report the case of a 51-year-old woman who presented with dysarthria and tongue fasciculation. MRI revealed an atlantoaxial synovial cyst that extended cranially through the hypoglossal canal and compressed the fibres of the left XII nerve on its cisternal segment. To our knowledge, this is the first case report of XII nerve paralysis being caused by an atlantoaxial synovial cyst.
Assuntos
Articulação Atlantoaxial , Doenças dos Nervos Cranianos/etiologia , Doenças do Nervo Hipoglosso/etiologia , Síndromes de Compressão Nervosa/etiologia , Cisto Sinovial/complicações , Idoso , Idoso de 80 Anos ou mais , Doenças dos Nervos Cranianos/diagnóstico , Diagnóstico Diferencial , Disartria/etiologia , Fasciculação/etiologia , Feminino , Humanos , Doenças do Nervo Hipoglosso/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/fisiopatologia , Cisto Sinovial/diagnóstico , Doenças da Língua/etiologia , Doenças da Língua/patologiaRESUMO
In this study, we evaluated patients with pulmonary arterial hypertension (PAH) and impaired right ventricular function. We used cardiac MRI for the detection of myocardial delayed enhancement (MDE) and its possible association with other clinical variables. 20 patients (6 males and 14 females, aged 44.5+/-11 years; 15 New York Heart Association class III, 5 class IV) with known PAH (13 idiopathic, 7 resulting from chronic pulmonary embolism) were evaluated for the detection of MDE. Short-axis cine images of the heart were made for ventricular function assessment using a steady-state free precession sequence. For MDE evaluation, a short-axis phase-sensitive inversion recovery sequence was performed 10 min after intravenous administration of 0.2 mmol kg(-1) gadodiamide. Right ventricle (RV) systolic dysfunction, RV enlargement and RV hypertrophy were present in 20 patients (RV ejection fraction, 21.5+/-7.2%; RV diastolic diameter, 5.97+/-0.79 cm; RV wall thickness, 0.73+/-0.10 cm). 13 of the 20 patients (65%) were positive for MDE (10 anterior, 12 inferior). All 13 positive patients with MDE demonstrated small hyperintense areas at the insertion points of the RV free wall in the interventricular septum. We found no significant correlation between MDE and ejection fraction or other haemodynamic variables. In this study, MDE correlated positively only with the duration of disease. We found that septal MDE can be present in patients with PAH and impaired ventricular function. However, further studies are necessary to investigate this possible association and its prognostic implication.
Assuntos
Hipertensão Pulmonar/diagnóstico , Disfunção Ventricular Direita/diagnóstico , Adulto , Idoso , Meios de Contraste , Feminino , Gadolínio DTPA , Humanos , Hipertensão Pulmonar/fisiopatologia , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Disfunção Ventricular Direita/fisiopatologiaRESUMO
The purpose of this study is to report a case of infra-renal aorta agenesis with emphasis on the MR angiography (MRA) findings. A 66-year-old woman presented with urinary complaints. Pelvic and abdominal ultrasound showed hydronephrosis secondary to ureteral lithiasis; the distal portion of the abdominal aorta was not identified. Abdominal CT showed that the infra-renal portion of the abdominal aorta was apparently absent. MRI and MRA demonstrated that, after the origin of the renal arteries, the abdominal aorta spontaneously terminated in two lumbar hypertrophic arteries. In addition, MRA showed a dilated superior mesenteric artery that formed a vascular loop, which continued posterior and inferiorly towards the posterior pelvic region. In this region, it bifurcated and formed internal iliac branches, which were responsible for the arterial supply of the pelvis. In conclusion, MRA allows for precise evaluation of patients with infra-renal abdominal aorta agenesis. Although it is a rare entity, radiologists should be able to recognize it in ultrasound, CT and MRI studies.
Assuntos
Aorta Abdominal/anormalidades , Angiografia por Ressonância Magnética/métodos , Idoso , Aorta Abdominal/diagnóstico por imagem , Feminino , Humanos , Achados Incidentais , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
BACKGROUND AND PURPOSE: The T2-weighted gradient-echo (GRE) imaging is currently the gold standard MR imaging sequence for the evaluation of patients with cerebral cavernous malformation (CCM) lesions. We aimed to compare the sensitivity of susceptibility-weighted imaging (SWI) with T2-weighted fast spin-echo (FSE) and GRE imaging in assigning the number of CCM lesions in patients with the familial form of the disease. MATERIALS AND METHODS: We studied 15 patients (8 men, 7 women; mean age, 34 years) with familial CCM. All patients underwent MR imaging with the following sequences: T1-weighted spin echo, T2-weighted FSE, T2-weighted GRE, and SWI. Two neuroradiologists read the images regarding the number of lesions seen on each sequence. The final decisions were reached by consensus. The number of lesions on the different sequences was compared with analysis of variance, followed by a nonparametric Wilcoxon matched-pairs signed rank test. RESULTS: The number of lesions was higher on T2-weighted GRE than on T2-weighted FSE (P = .001). In addition, more lesions were seen on SWI than on T2-weighted GRE (P = .001) and FSE (P = .001) sequences. CONCLUSION: The sensitivity of SWI in assigning the number of CCM lesions in patients with the familial form of the disease is significantly higher than that of T2-weighted FSE and GRE sequences.
Assuntos
Algoritmos , Veias Cerebrais/anormalidades , Veias Cerebrais/patologia , Imagem Ecoplanar/métodos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Malformações Arteriovenosas Intracranianas/diagnóstico , Adulto , Feminino , Predisposição Genética para Doença , Humanos , Malformações Arteriovenosas Intracranianas/genética , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Marcadores de SpinRESUMO
The authors aim to report the chest CT findings of a patient with disseminated cysticercosis, emphasising the pulmonary and cardiac features. The main finding consisted of multiple pulmonary, cardiac and chest wall nodules. The present case demonstrates that cysticercosis should be considered in the differential diagnosis of multiple pulmonary nodules, mainly in those patients with similar lesions in the cardiac muscle and/or in the chest wall.
Assuntos
Cardiomiopatias/diagnóstico por imagem , Cisticercose/diagnóstico por imagem , Pneumopatias Parasitárias/diagnóstico por imagem , Tomografia Computadorizada Espiral , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Nódulo Pulmonar Solitário/diagnóstico por imagemRESUMO
A 6-year-old female patient who underwent bone marrow transplantation because of Fanconi anaemia presented with fever, dyspnoea and cough 17 days after the procedure. The physical examination revealed diffuse crackles. Chest radiographs demonstrated diffuse alveolar opacities in both lungs. High-resolution CT showed a diffuse and bilateral lung lesion characterized by multifocal areas of air-space consolidation associated with ground-glass attenuation and small centrilobular nodules. The culture of the material obtained with bronchoalveolar lavage only demonstrated growth of Stenotrophomonas maltophilia. The patient rapidly presented respiratory insufficiency and death in the same day.
Assuntos
Transplante de Medula Óssea , Anemia de Fanconi/terapia , Infecções por Bactérias Gram-Negativas/diagnóstico por imagem , Pneumonia Bacteriana/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Criança , Feminino , Infecções por Bactérias Gram-Negativas/etiologia , Humanos , Pneumonia Bacteriana/etiologia , Stenotrophomonas maltophiliaRESUMO
Physical examination demonstrated petechiae, leg oedema and mild dyspnoea. Chest radiograph showed minimal bilateral hazy increased opacification, mainly on the right side, and small bilateral pleural effusions. High-resolution CT demonstrated extensive bilateral ground-glass opacities most severe in the middle and lower lung zones. Also noted were a few slightly thickened interlobular septa, a few poorly defined small nodules, bronchial wall thickening and small bilateral pleural effusions. Blood tests revealed high leukocyte and low platelet counts. Renal function was normal. Serological test (ELISA) for hantavirus using SNV (Sin Nombre virus) antigen was positive. The patient received supportive treatment, gradually improved, and was discharged 10 days after hospital admission. His symptoms completely resolved and follow-up radiographs returned to normal.
Assuntos
Síndrome Pulmonar por Hantavirus/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Humanos , MasculinoRESUMO
The aim of this study was to describe the high-resolution CT scan findings in five patients with AIDS and pulmonary infection due to Rhodococcus equi. The study included five patients with AIDS and proven R. equi infection. The CT scans were reviewed by two observers. The patients included four men and one woman ranging from 39 years to 49 years in age (mean 42 years). The findings included areas of consolidation (n=5) with single (n=1) or multiple cavitation (n=4), ground-glass opacities (n=5), centrilobular nodules (n=3), small centrilobular nodular opacities (n=3) and "tree in bud" opacities (n=3). None of the patients had pleural effusion or lymph node enlargement. The most common high-resolution CT manifestations of R. equi infection consist of areas of consolidation with cavitation, ground-glass opacities, nodules and a tree-in-bud pattern.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Infecções por Actinomycetales/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Rhodococcus equi , Tomografia Computadorizada por Raios X/métodos , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções por Actinomycetales/complicações , Adulto , Feminino , Humanos , Pneumopatias/complicações , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Pulmonary alveolar microlithiasis (PAM) is an uncommon chronic disease characterized by calcifications within the alveoli and a paucity of symptoms in contrast to the imaging findings. We present a 59-year-old woman with a 4-year history of shortness of breath on exertion. Lung auscultation revealed random wheezes and fine and coarse crackles. Pulmonary function tests showed a restrictive pattern. The chest radiograph demonstrated a bilateral symmetric micronodular pattern. High resolution CT scan revealed diffuse ground-glass attenuation with superimposed septal thickening ("crazy-paving" pattern). The patient underwent a lung biopsy, which confirmed the diagnosis of PAM. Our case demonstrates that PAM needs to be considerate in the differential diagnosis of lung lesions that present with crazy-paving pattern on the high resolution CT.
Assuntos
Cálculos/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Alvéolos Pulmonares/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Doença Crônica , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Cytomegalovirus (CMV) pneumonia is one of the most common pulmonary complications after bone marrow transplantation (BMT). We describe the high resolution CT (HRCT) findings of 13 patients with CMV pneumonia diagnosed after allogenic BMT. The study included 13 consecutive patients who developed CMV pneumonia after BMT and who had HRCT of the chest performed within 24 h of the onset of symptoms. HRCT scans were reviewed by two radiologists who assessed pattern and distribution of findings. There were nine male and four female patients, ranging from 9 years to 56 years of age (mean age 33 years). BMT was performed for treatment of chronic myelogenous leukaemia (54%), severe aplastic anaemia (23%), acute myelogenous leukaemia (15%) and Fanconi's anaemia (8%). The time elapsed until diagnosis ranged from +18 days to +405 days (median of 54 days, mean +81.6 days). The predominant patterns of abnormality on HRCT scans were ground-glass opacities (69%), small centrilobular nodules (69%) and air-space opacities (54%). The abnormalities were distributed in the central and peripheral zones of the lungs in six cases, only in the periphery in four cases, and only in the central zone in three cases. In all cases the lung lesions were bilateral, and asymmetry was observed in seven cases. The authors conclude that the most common HRCT findings in patients with CMV pneumonia after BMT consist of bilateral asymmetric ground-glass, air-space opacities and small centrilobular nodules.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Infecções por Citomegalovirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Criança , Infecções por Citomegalovirus/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/etiologia , Transplante HomólogoRESUMO
Autopsy files of 180 patients were reviewed, who died after BMT between July 1987 and June 1998 and 58 (32.2%) cases, who had experienced intracranial hemorrhage (ICH) were selected. Age, sex, underlying disease, preparatory regimens, immunoprophylaxis, chronic and acute GVHD, survival of the patients and localization and size of hemorrhages were evaluated. There were 33 males and 25 females, with a mean age of 23.4 years. The main underlying disorders for which BMT was performed included SAA (n = 21), CML (n = 13) and AML (n = 10). Forty patients were found to have intraparenchymal hemorrhage, 35 had subarachnoid hemorrhage and eight patients had subdural hemorrhage. In 16 cases the CNS hemorrhage was so extensive that it was considered to be the main cause of death. There was no significant statistical difference concerning sex (P = 0.217), age (P = 0.296), underlying disease (P= 0.352), preparatory regimens (P = 0.07), immunoprophylaxis (P = 0.914), chronic and acute graft-versus-host disease (P = 0.107 and P = 0.631, respectively) and survival (P = 0.701) when comparing patients with or without ICH. However, the number of cases in which the CNS was defined as the main cause of death was higher among patients with ICH than in patients without ICH (n = 16 vs 15) (P = 0.011). We conclude that ICH is common and has a significant mortality rate following BMT.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Hemorragias Intracranianas/etiologia , Adolescente , Adulto , Autopsia , Brasil/epidemiologia , Estudos de Casos e Controles , Causas de Morte , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Doença Enxerto-Hospedeiro , Doenças Hematológicas/complicações , Doenças Hematológicas/mortalidade , Doenças Hematológicas/terapia , Humanos , Hemorragias Intracranianas/mortalidade , Hemorragias Intracranianas/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Taxa de SobrevidaRESUMO
Cerebrovascular diseases in patients between 15 and 40 years old are not a frequent subject in Latin-American literature, especially when focusing on neuropathology. We analyzed 47 brains from necropsies performed from 1987 to 1997 and selected on a basis of age and the presence of vascular pathology. From the 47 analyzed brains, 26 belonged to females (55.3%). When distributed among age groups, 12.8% (n=6) affected patients from 15 to 20 yo, 51,1% (n=24) from 21 to 30 yo, 36,2% (n=17) from 31 to 40 yo. The underlying diseases were: cardiac and haemathologic (19.2%), pregnancy complications (12.76%), infections, diseases of blood vessels and neurological (10.1% each) amongst others. The neuropathological abnormalities included cerebral and/or cerebellar herniation (16%), cerebral edema (13.8%), subarachnoid hemorrhage (10%), recent cerebral infarction (9%), intraparenchymatous hemorrhage (8.14%), hypoxic-ischemic encephalopathy (3%) and other events such as Sneddon syndrome and Lupus vasculitis. These findings express that the cerebrovascular phenomena in this age group are unique and closely related with the underlying disease.
Assuntos
Transtornos Cerebrovasculares/patologia , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Transtornos Cerebrovasculares/etiologia , Feminino , Cardiopatias/etiologia , Cardiopatias/patologia , Doenças Hematológicas/etiologia , Doenças Hematológicas/patologia , Humanos , Masculino , Distribuição por SexoRESUMO
Meningiomas correspond to 1% - 4% of primary intracranial tumors in pediatric group, with their incidence raising according to age. There is not gender prevalence, in spite of some authors describe a male tendency opposed to female one in adulthood. At present study we describe two cases of pediatric meningiomas reviewing clinical, radiological and histological aspects of these lesions. The authors review also treatment options and prognosis of childhood meningiomas. A two-year-old boy was admitted with seizures. Computerized tomography showed a right parietal lesion, which was totally resected. Histological features were compatible with meningioma. After 17 months the child is doing well, with no deficits or seizures. The second case is a 12-year-old girl, with a headache complain. During investigation, a CT revealed a right frontal lesion. She was operated under a right frontal craniotomy with total tumor resection. Nowadays she is asymptomatic, 20 months after surgery. Despite meningiomas in pediatric group are uncommon; they should be included in differential diagnosis list of expansive intracranial lesions of childhood.
Assuntos
Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgiaRESUMO
Central neurocytoma was first described by Hassoun et al. in 1982 as a well-differentiated tumor from neuronal origin. This tumor typically occurs in young adults, localized in the ventricular system. It usually presents as intracranial hypertension due to obstructive hydrocephalus. The differential diagnosis should be done with others intraventricular tumors as oligodendroglioma, subependymoma and choroidal plexus papilloma. There are few cases of central neurocytoma presented by intraventricular hemorrhage in the literature. We report a case of 35 year-old woman, who presented with obstructive hydrocephalus due to intraventricular hemorrhage within the tumor. MRI revealed a tumor localized in the right lateral ventricle. Histopathological and immunohystochemical analysis confirmed the diagnosis of central neurocytoma. We review options for the treatment of this entity as well reinforce the inclusion of central neurocytoma as a differential diagnosis for intraventricular hemorrhage.