RESUMO
Although imaging and clinical criteria are already established for the diagnosis of mucoid degeneration of the anterior cruciate ligament (ACL), many radiologists remain unaware of their existence. Once regarded as a rare occurrence, it has been recently suggested that its incidence is in fact very much higher than previously thought, and that it is probably underdiagnosed or misdiagnosed as partial ruptures of the ACL or as cystic ganglia. In this review, the authors revisit the literature concerning this subject and present their personal experience with it, stressing the paramount importance of magnetic resonance imaging and correlation with clinical data for a correct diagnosis.
Assuntos
Ligamento Cruzado Anterior/patologia , Artropatias/diagnóstico , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética/métodos , Envelhecimento , Diagnóstico Diferencial , Cistos Glanglionares/diagnóstico , Humanos , Muco , Amplitude de Movimento ArticularRESUMO
In this report seven cases of diffusely altered signal intensity of the posterior cruciate ligament (PCL) at magnetic resonance imaging (MRI) are described. The abnormalities resemble those of mucoid degeneration of the anterior cruciate ligament (ACL) and are associated with it in six cases. Although mucoid degeneration of the ACL is an increasingly reported entity, with well-established imaging criteria at MRI, to the authors' knowledge similar findings were never described before for the PCL. It is hypothesized that these abnormalities of the cruciate ligaments are similar in nature, probably related to degenerative changes of the connective tissue.
Assuntos
Ligamento Cruzado Anterior/patologia , Doenças do Tecido Conjuntivo/diagnóstico , Artropatias/diagnóstico , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética/métodos , Ligamento Cruzado Posterior/patologia , Adulto , Idoso , Doenças do Tecido Conjuntivo/complicações , Feminino , Humanos , Artropatias/complicações , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Amplitude de Movimento ArticularRESUMO
Pseudotumoural hemicerebellitis is exceedingly rare. It may closely resemble a tumour either clinically or on imaging, and a high index of suspicion is required to avoid unnecessary surgical procedures. MRI is the most useful diagnostic tool, and reveals a swollen cerebellar hemisphere, hyperintense in T(2) weighted images. A pattern of predominantly pial contrast enhancement, absence of a well-defined mass and regression of the abnormalities in follow up examinations help to rule out malignancy. We report two cases of pseudotumoural cerebellitis (an 11-year-old girl and a 9-year-old boy) studied with CT and MRI.
Assuntos
Doenças Cerebelares/diagnóstico , Encefalite/diagnóstico , Neoplasias Cerebelares/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
An unusual disorder of cerebellar development, rhombencephalosynapsis is a unique entity which presents with cerebellar fusion and absence of cerebellar vermis on imaging studies, often associated with supratentorial findings. No specific clinical syndrome has been described in these patients so far, and most cases are found in infancy and childhood. MRI and its multiplanar capabilities and high spatial and contrast resolution increased its recognition. Two cases are reported, with emphasis on imaging findings.
Assuntos
Cerebelo/anormalidades , Fossa Craniana Posterior/anormalidades , Rombencéfalo/anormalidades , Adolescente , Adulto , Cerebelo/diagnóstico por imagem , Cerebelo/patologia , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Radiografia , Rombencéfalo/diagnóstico por imagem , Rombencéfalo/patologiaRESUMO
The authors report a case of a 5 months old female child with clinical features of Aicardi syndrome: agenesis of the corpus callosum, occular abnormalities ("chorioretinal lacunae" and microphthalmus), infantile spasms, mental retardation, vertebral malformations and thoracic deformity. The pacient was submitted to complementary examinations that confirmed the diagnosis. The neuroradiologic images (MRI) showed besides corpus callosum agenesis a tumor located at the left ventricular atrium (choroid plexus papilloma). This association is a rare occurrence and the present case is the seventh described in literature. Furthermore, we suggest that the choroid plexus pappilloma could be a characteristic tumor of the Aicardi syndrome.
Assuntos
Agenesia do Corpo Caloso , Neoplasias do Plexo Corióideo/diagnóstico , Anormalidades do Olho/diagnóstico , Glioma/diagnóstico , Deficiência Intelectual/diagnóstico , Espasmos Infantis/diagnóstico , Feminino , Humanos , Lactente , Espectroscopia de Ressonância Magnética , Síndrome , Tomografia Computadorizada por Raios XRESUMO
Three new cases of human infection with Lagochilascaris minor are reported. All the patients were from the state of Pará (Brazil), living in rural areas or close to the forest. They were admitted to hospitals in the Federal District due to the presence of abscesses in the region of the neck, ear, mastoid process and, in two of them, to the involvement also of the central nervous system. Microscopic examination of tissue samples taken from the lesions showed sections of eggs and worms--in different evolutive stages--identified as Lagochilascaris minor. Larvae and adult worms obtained from existing fistulae proved also to be of the same species. The three patients were treated with anthelmintic drugs and surgical excision of the lesions, with good clinical results. In two of them, however, relapsing occurred, suggesting that the drugs do not destroy the worm eggs, in spite of the apparent healing of the lesions.
Assuntos
Infecções por Nematoides/patologia , Adolescente , Adulto , Animais , Antinematódeos/administração & dosagem , Brasil , Criança , Terapia Combinada , Quimioterapia Combinada , Feminino , Humanos , Nematoides/isolamento & purificação , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Infecções por Nematoides/cirurgia , RecidivaRESUMO
The authors report a case of symptomatic basilar impression and Arnold-Chiari malformation being presented as the first symptom of hemifacial spasm. The surgical treatment of the malformation resulted in improvement of the clinical manifestation with reduction of the hemifacial spasm. The need for the aetiological therapy for the hemifacial spasm is emphasized, before symptomatic treatment with botulinum toxin is tried.
Assuntos
Malformação de Arnold-Chiari/complicações , Músculos Faciais , Platibasia/complicações , Espasmo/complicações , Malformação de Arnold-Chiari/diagnóstico por imagem , Malformação de Arnold-Chiari/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Mielografia , Platibasia/diagnóstico por imagem , Platibasia/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Seven cases of compromised pituitary fossa at the conventional skull X-ray, who had the final diagnosis of giant aneurysm of the intracavernous portion of the carotid artery (6 cases) and one of the anterior communicating artery, are reported. The main findings were: headache (7/7), complex ophthalmoplegia involving the III, IV and VI cranial nerves (5/7), compromised V cranial nerve (4/7) and eyeball pain (4/7). Other manifestations were: meningeal signs (2/7), unilateral blindness (1/7), hemiparesis (1/7), cacosmia (1/7) and inferior bitemporal quadrantanopsia (1/7). Five patients with intracavernous carotid artery aneurysm showed benefits with progressive occlusion of the internal carotid artery at the cervical level. One died before surgery. The case with anterior communicating artery aneurysm improved after its surgical clipping. Our data, in accord with the literature, support the conclusion that the differential diagnosis of aneurysms in the parasellar region remains a very difficult task. The accurate final diagnosis requires cerebral angiography and the surgical treatment with progressive occlusion at the cervical portion of the internal carotid artery has a relatively low risk with promising results.