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Radiology Case Reports Apr 2024Microcystic meningioma is an uncommon subtype of World Health Organization grade 1 meningiomas often associated with a shorter progression-free survival. Diagnosis...
Microcystic meningioma is an uncommon subtype of World Health Organization grade 1 meningiomas often associated with a shorter progression-free survival. Diagnosis through imaging alone can often be challenging due to atypical characteristics, especially when found in unexpected locations. Here, we present a 55-year-old woman who was diagnosed, based on imaging, with a posterior fossa arachnoid cyst 5 years prior after complaints of headaches and gait imbalance. After surgical resection of the "arachnoid cyst," the diagnosis of microcystic meningioma was made. This case report emphasizes the clinical importance and challenges associated with diagnosing microcystic meningiomas.
PubMed: 38292808
DOI: 10.1016/j.radcr.2023.12.065 -
Radiology Case Reports Apr 2024Dorsal arachnoid webs are uncommon, and of uncertain etiology. We present a case in which imaging findings of a dorsal arachnoid web were identified at the level of a...
Dorsal arachnoid webs are uncommon, and of uncertain etiology. We present a case in which imaging findings of a dorsal arachnoid web were identified at the level of a known prior gunshot injury where a retained bullet was lodged adjacent to the spine, without associated penetrating injury to the spine, suggesting blunt post-traumatic etiology.
PubMed: 38292796
DOI: 10.1016/j.radcr.2024.01.004 -
Journal of Global Infectious Diseases 2023Tuberculous meningitis causes substantial morbidity and mortality in tropical countries. The various complications reported are hydrocephalus, vasculitic infarcts,...
Tuberculous meningitis causes substantial morbidity and mortality in tropical countries. The various complications reported are hydrocephalus, vasculitic infarcts, tuberculomas, abscesses, and optochiasmatic arachnoiditis. Vasculitis in tuberculosis is basically at the level of lenticulostriate arteries supplying the basal ganglia and terminal cortical branches. In this case report, we present a rare case of tuberculous meningitis with extensive vasculopathy. During hospitalization, she developed acute onset right-sided classical hemiplegia with the inability to speak due to left internal carotid artery occlusion on imaging. The cerebrospinal fluid depicted very high protein levels. The exact pathogenesis of such extensive involvement in tuberculous meningitis substantiates the need for further studies.
PubMed: 38292690
DOI: 10.4103/jgid.jgid_24_23 -
Frontiers in Neurology 2023The rhomboid lip (RL) is a layer of neural tissue that extends outside the fourth ventricle and is connected to the lateral recess of the fourth ventricle. Although this...
The rhomboid lip (RL) is a layer of neural tissue that extends outside the fourth ventricle and is connected to the lateral recess of the fourth ventricle. Although this anatomical structure has been rigorously studied, it is often overlooked in microvascular decompression (MVD) surgery. In this report, we present two cases, one of hemifacial spasm (HFS) and one of glossopharyngeal neuralgia (GPN), in which a large RL was observed during surgery. We found that a large RL is easily confused with arachnoid cysts, and accurate identification and dissection are important to protect the lower cranial nerves.
PubMed: 38292034
DOI: 10.3389/fneur.2023.1336273 -
Journal of Neurosurgery. Case Lessons Jan 2024Arachnoid cysts are often congenital, asymptomatic lesions detected in the pediatric population. When seen in adults, they usually occur following trauma. De novo...
BACKGROUND
Arachnoid cysts are often congenital, asymptomatic lesions detected in the pediatric population. When seen in adults, they usually occur following trauma. De novo formation of arachnoid cysts is uncommon, with only a few instances cited in the literature and most of which occurred in the pediatric population. Treatment options for these lesions include observation, craniotomy for cyst resection, microsurgical/endoscopic fenestration, or shunting.
OBSERVATIONS
In this report, the authors describe a female patient with a de novo, symptomatic, enlarging middle cranial fossa arachnoid cyst detected at age 16 years. She was treated with the placement of a cystoperitoneal shunt. After surgery, she experienced clinical and radiological improvement.
LESSONS
We illustrate successful shunting of a de novo arachnoid cyst in a symptomatic teen patient. Although arachnoid cysts in certain intracranial locations are more likely to produce symptoms, those in the middle cranial fossa tend to be asymptomatic. To our knowledge, this is the first reported case of a symptomatic de novo arachnoid cyst located in the middle cranial fossa in a postpubertal patient. Although the current presentation is rare, the authors demonstrate an effective surgical treatment of a symptomatic, large, de novo arachnoid cyst in a postpubertal pediatric patient.
PubMed: 38285974
DOI: 10.3171/CASE23584