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| __NOTOC__ | | __NOTOC__ |
| | {{Arteriovenous malformations}} |
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| {{CMG}}; {{AE}} {{Fs}}
| | Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing. |
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| ==Overview== | | ==References== |
| On the basis of seizure, visual disturbance, and constitutional symptoms, astrocytoma must be differentiated from [[oligodendroglioma]], [[meningioma]], [[hemangioblastoma]], [[pituitary adenoma]], [[schwannoma]], [[Primary central nervous system lymphoma|primary CNS lymphoma]], [[medulloblastoma]], [[ependymoma]], [[craniopharyngioma]], [[pinealoma]], [[Arteriovenous malformation|AV malformation]], [[brain aneurysm]], [[bacterial]] [[brain]] [[abscess]], [[tuberculosis]], [[toxoplasmosis]], [[hydatid cyst]], [[CNS]] [[cryptococcosis]], [[CNS]] [[aspergillosis]], and [[brain metastasis]].
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| == Differentiating astrocytoma from other Diseases ==
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| === Differentiating astrocytoma from other diseases on the basis of seizure, visual disturbance, and constitutional symptoms ===
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| On the basis of seizure, visual disturbance, and constitutional symptoms, astrocytoma must be differentiated from [[oligodendroglioma]], [[meningioma]], [[hemangioblastoma]], [[pituitary adenoma]], [[schwannoma]], [[Primary central nervous system lymphoma|primary CNS lymphoma]], [[medulloblastoma]], [[ependymoma]], [[craniopharyngioma]], [[pinealoma]], [[Arteriovenous malformation|AV malformation]], [[brain aneurysm]], [[bacterial]] [[brain]] [[abscess]], [[tuberculosis]], [[toxoplasmosis]], [[hydatid cyst]], [[CNS]] [[cryptococcosis]], [[CNS]] [[aspergillosis]], and [[brain metastasis]].
| |
| {|
| |
| |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
| |
| ! colspan="2" rowspan="4" |Diseases
| |
| | colspan="5" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
| |
| ! colspan="3" rowspan="2" |Para-clinical findings
| |
| | colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold<br>standard'''
| |
| ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
| |
| |-
| |
| | colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
| |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
| |
| |-
| |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
| |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI
| |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immunohistopathology
| |
| |-
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Head-<br>ache
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Seizure
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Visual disturbance
| |
| ! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constitutional
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Focal neurological deficit
| |
| | |
| |-
| |
| | rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |Childhood primary brain tumors
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pilocytic astrocytoma]]<br><ref name="pmid179640282">{{cite journal |vauthors=Sathornsumetee S, Rich JN, Reardon DA |title=Diagnosis and treatment of high-grade astrocytoma |journal=Neurol Clin |volume=25 |issue=4 |pages=1111–39, x |date=November 2007 |pmid=17964028 |doi=10.1016/j.ncl.2007.07.004 |url=}}</ref><ref name="pmid228197182">{{cite journal |vauthors=Pedersen CL, Romner B |title=Current treatment of low grade astrocytoma: a review |journal=Clin Neurol Neurosurg |volume=115 |issue=1 |pages=1–8 |date=January 2013 |pmid=22819718 |doi=10.1016/j.clineuro.2012.07.002 |url=}}</ref><ref name=":02">{{cite book | last = Mattle | first = Heinrich | title = Fundamentals of neurology : an illustrated guide | publisher = Thieme | location = Stuttgart New York | year = 2017 | isbn = 9783131364524 }}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Infratentorial]]
| |
| | |
| * Solid and [[Cyst|cystic]] component
| |
| * Mostly in [[posterior fossa]]
| |
| * Usually in [[Cerebellar hemisphere|cerebellar hemisphers]] and [[Cerebellar vermis|vermis]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Glial cell]] origin
| |
| *Solid and [[Cyst|cystic]] component
| |
| | |
| * [[GFAP]] +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Most of the time, [[Cerebellum|cerebellar]] dysfunction is the presenting [[signs]].
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Medulloblastoma]]<br><ref name="DorwartWara1981">{{cite journal|last1=Dorwart|first1=R H|last2=Wara|first2=W M|last3=Norman|first3=D|last4=Levin|first4=V A|title=Complete myelographic evaluation of spinal metastases from medulloblastoma.|journal=Radiology|volume=139|issue=2|year=1981|pages=403–408|issn=0033-8419|doi=10.1148/radiology.139.2.7220886}}</ref><ref name="Fruehwald-PallamarPuchner2011">{{cite journal|last1=Fruehwald-Pallamar|first1=Julia|last2=Puchner|first2=Stefan B.|last3=Rossi|first3=Andrea|last4=Garre|first4=Maria L.|last5=Cama|first5=Armando|last6=Koelblinger|first6=Claus|last7=Osborn|first7=Anne G.|last8=Thurnher|first8=Majda M.|title=Magnetic resonance imaging spectrum of medulloblastoma|journal=Neuroradiology|volume=53|issue=6|year=2011|pages=387–396|issn=0028-3940|doi=10.1007/s00234-010-0829-8}}</ref><ref name="BurgerGrahmann1987">{{cite journal|last1=Burger|first1=P. C.|last2=Grahmann|first2=F. C.|last3=Bliestle|first3=A.|last4=Kleihues|first4=P.|title=Differentiation in the medulloblastoma|journal=Acta Neuropathologica|volume=73|issue=2|year=1987|pages=115–123|issn=0001-6322|doi=10.1007/BF00693776}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Infratentorial]]
| |
| | |
| * Mostly in [[cerebellum]]
| |
| | |
| * Non communicating [[hydrocephalus]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Neuroectoderm]] origin
| |
| | |
| * Homer wright rosettes
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Drop metastasis]] ([[metastasis]] through [[CSF]])
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ependymoma]]<br><ref name="YuhBarkovich2009">{{cite journal|last1=Yuh|first1=E. L.|last2=Barkovich|first2=A. J.|last3=Gupta|first3=N.|title=Imaging of ependymomas: MRI and CT|journal=Child's Nervous System|volume=25|issue=10|year=2009|pages=1203–1213|issn=0256-7040|doi=10.1007/s00381-009-0878-7}}</ref><ref name=":0" />
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Infratentorial]]
| |
| | |
| * Usually found in [[Fourth ventricle|4th ventricle]]
| |
| * Mixed [[Cyst|cystic]]/solid [[lesion]]
| |
| | |
| * Hydrocephalus
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Ependymal cell]] origin
| |
| | |
| * Peri[[vascular]] pseudorosette
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Causes an unusually persistent, continuous [[headache]] in children.
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Craniopharyngioma]]<br><ref name="pmid12407316">{{cite journal |vauthors=Brunel H, Raybaud C, Peretti-Viton P, Lena G, Girard N, Paz-Paredes A, Levrier O, Farnarier P, Manera L, Choux M |title=[Craniopharyngioma in children: MRI study of 43 cases] |language=French |journal=Neurochirurgie |volume=48 |issue=4 |pages=309–18 |date=September 2002 |pmid=12407316 |doi= |url=}}</ref><ref name="PrabhuBrown2005">{{cite journal|last1=Prabhu|first1=Vikram C.|last2=Brown|first2=Henry G.|title=The pathogenesis of craniopharyngiomas|journal=Child's Nervous System|volume=21|issue=8-9|year=2005|pages=622–627|issn=0256-7040|doi=10.1007/s00381-005-1190-9}}</ref><ref name="pmid766825">{{cite journal |vauthors=Kennedy HB, Smith RJ |title=Eye signs in craniopharyngioma |journal=Br J Ophthalmol |volume=59 |issue=12 |pages=689–95 |date=December 1975 |pmid=766825 |pmc=1017436 |doi= |url=}}</ref><ref name=":0" />
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | + [[Bitemporal hemianopia]]
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Hypopituitarism]] as a result of pressure effect on [[pituitary gland]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Calcification]]
| |
| * Lobulated contour
| |
| * Motor-oil like fluid within [[tumor]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Ectoderm|Ectodermal]] origin ([[Rathke's pouch|Rathkes pouch]])
| |
| | |
| * [[Calcification]] +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Initialy presents with lower bitemporal quadrantanopsia followed by [[Bitemporal hemianopia|bitemporal hemianopsia]] (pressure on [[Optic chiasm|optic chiasma]] from above)
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pinealoma]]<br><ref name="pmid6625640">{{cite journal |vauthors=Ahmed SR, Shalet SM, Price DA, Pearson D |title=Human chorionic gonadotrophin secreting pineal germinoma and precocious puberty |journal=Arch. Dis. Child. |volume=58 |issue=9 |pages=743–5 |date=September 1983 |pmid=6625640 |doi= |url=}}</ref><ref name="Sano1976">{{cite journal|last1=Sano|first1=Keiji|title=Pinealoma in Children|journal=Pediatric Neurosurgery|volume=2|issue=1|year=1976|pages=67–72|issn=1016-2291|doi=10.1159/000119602}}</ref><ref name="Baggenstoss1939">{{cite journal|last1=Baggenstoss|first1=Archie H.|title=PINEALOMAS|journal=Archives of Neurology And Psychiatry|volume=41|issue=6|year=1939|pages=1187|issn=0096-6754|doi=10.1001/archneurpsyc.1939.02270180115011}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | + vertical gaze palsy
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * B-hCG rise leads to [[precocious puberty]] in [[Male|males]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Hydrocephalus]] (compression of [[cerebral aqueduct]])
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Similar to [[testicular seminoma]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * May cause prinaud syndrome ([[Vertical gaze center|vertical gaze]] palsy, pupillary light-near dissociation, lid retraction and convergence-retraction [[nystagmus]]
| |
| |-
| |
| | rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |Adult primary brain tumors
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Glioblastoma multiforme]]<br><ref name="pmid17964028">{{cite journal |vauthors=Sathornsumetee S, Rich JN, Reardon DA |title=Diagnosis and treatment of high-grade astrocytoma |journal=Neurol Clin |volume=25 |issue=4 |pages=1111–39, x |date=November 2007 |pmid=17964028 |doi=10.1016/j.ncl.2007.07.004 |url=}}</ref><ref name="pmid22819718">{{cite journal |vauthors=Pedersen CL, Romner B |title=Current treatment of low grade astrocytoma: a review |journal=Clin Neurol Neurosurg |volume=115 |issue=1 |pages=1–8 |date=January 2013 |pmid=22819718 |doi=10.1016/j.clineuro.2012.07.002 |url=}}</ref><ref name=":0">{{cite book | last = Mattle | first = Heinrich | title = Fundamentals of neurology : an illustrated guide | publisher = Thieme | location = Stuttgart New York | year = 2017 | isbn = 9783131364524 }}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Supratentorial]]
| |
| * Irregular ring-nodular enhancing lesions
| |
| * Central [[necrosis]]
| |
| * Surrounding [[vasogenic edema]]
| |
| | |
| * Cross [[corpus callosum]] ([[butterfly glioma]])
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Astrocyte]] origin
| |
| | |
| * [[Pleomorphism|Pleomorphic]] cell
| |
| | |
| * Pseudopalisading appearance
| |
| | |
| * [[GFAP]] +
| |
| | |
| * [[Necrosis]] +
| |
| | |
| * [[Hemorrhage]] +
| |
| | |
| * [[Vascular]] prolifration +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Highest [[incidence]] in fifth and sixth decades of life
| |
| * Most of the time, focal [[neurological]] deficit is the presenting [[Sign (medical)|sign]].
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[oligodendroglioma]]<br><ref name="pmid26849038">{{cite journal |vauthors=Smits M |title=Imaging of oligodendroglioma |journal=Br J Radiol |volume=89 |issue=1060 |pages=20150857 |date=2016 |pmid=26849038 |pmc=4846213 |doi=10.1259/bjr.20150857 |url=}}</ref><ref name="pmid25943885">{{cite journal |vauthors=Wesseling P, van den Bent M, Perry A |title=Oligodendroglioma: pathology, molecular mechanisms and markers |journal=Acta Neuropathol. |volume=129 |issue=6 |pages=809–27 |date=June 2015 |pmid=25943885 |pmc=4436696 |doi=10.1007/s00401-015-1424-1 |url=}}</ref><ref name="pmid26478444">{{cite journal |vauthors=Kerkhof M, Benit C, Duran-Pena A, Vecht CJ |title=Seizures in oligodendroglial tumors |journal=CNS Oncol |volume=4 |issue=5 |pages=347–56 |date=2015 |pmid=26478444 |pmc=6082346 |doi=10.2217/cns.15.29 |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Almost always in [[Cerebral hemisphere|cerebral hemisphers]] ([[Frontal lobe|frontal lobes]])
| |
| | |
| * Hypointense on T1
| |
| * Hyperintense on T2
| |
| * [[Calcification]]
| |
| | |
| * Chicken wire capillary pattern
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Oligodendrocyte]] origin
| |
| | |
| * [[Calcification]] +
| |
| | |
| * Fried egg cell appearance
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Highest [[incidence]] is between 40 and 50 years of age.
| |
| * Most of the time, [[epileptic seizure]] is the presenting [[Sign (medicine)|sign]].
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Meningioma]]<br><ref name="pmid1642904">{{cite journal |vauthors=Zee CS, Chin T, Segall HD, Destian S, Ahmadi J |title=Magnetic resonance imaging of meningiomas |journal=Semin. Ultrasound CT MR |volume=13 |issue=3 |pages=154–69 |date=June 1992 |pmid=1642904 |doi= |url=}}</ref><ref name="pmid25744347">{{cite journal |vauthors=Shibuya M |title=Pathology and molecular genetics of meningioma: recent advances |journal=Neurol. Med. Chir. (Tokyo) |volume=55 |issue=1 |pages=14–27 |date=2015 |pmid=25744347 |doi=10.2176/nmc.ra.2014-0233 |url=}}</ref><ref name="pmid17509660">{{cite journal |vauthors=Begnami MD, Palau M, Rushing EJ, Santi M, Quezado M |title=Evaluation of NF2 gene deletion in sporadic schwannomas, meningiomas, and ependymomas by chromogenic in situ hybridization |journal=Hum. Pathol. |volume=38 |issue=9 |pages=1345–50 |date=September 2007 |pmid=17509660 |pmc=2094208 |doi=10.1016/j.humpath.2007.01.027 |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Well circumscribed
| |
| * Extra-axial [[mass]]
| |
| | |
| * [[Meninges|Dural]] attachment
| |
| * [[CSF]] [[vascular]] cleft sign
| |
| * Sunburst appearance of the [[Vessel|vessels]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Arachnoid]] origin
| |
| | |
| * [[Psammoma body|Psammoma bodies]]
| |
| | |
| * Whorled spindle cell pattern
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Highest [[incidence]] is between 40 and 50 years of age.
| |
| * Most of the time, focal [[neurological]] deficit and [[epileptic seizure]] are the presenting [[signs]].
| |
| | |
| * May be associated with [[Neurofibromatosis type II|NF-2]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemangioblastoma]]<br><ref name="pmid24579662">{{cite journal |vauthors=Lonser RR, Butman JA, Huntoon K, Asthagiri AR, Wu T, Bakhtian KD, Chew EY, Zhuang Z, Linehan WM, Oldfield EH |title=Prospective natural history study of central nervous system hemangioblastomas in von Hippel-Lindau disease |journal=J. Neurosurg. |volume=120 |issue=5 |pages=1055–62 |date=May 2014 |pmid=24579662 |pmc=4762041 |doi=10.3171/2014.1.JNS131431 |url=}}</ref><ref name="pmid17877533">{{cite journal |vauthors=Hussein MR |title=Central nervous system capillary haemangioblastoma: the pathologist's viewpoint |journal=Int J Exp Pathol |volume=88 |issue=5 |pages=311–24 |date=October 2007 |pmid=17877533 |pmc=2517334 |doi=10.1111/j.1365-2613.2007.00535.x |url=}}</ref><ref name="pmid2704812">{{cite journal |vauthors=Lee SR, Sanches J, Mark AS, Dillon WP, Norman D, Newton TH |title=Posterior fossa hemangioblastomas: MR imaging |journal=Radiology |volume=171 |issue=2 |pages=463–8 |date=May 1989 |pmid=2704812 |doi=10.1148/radiology.171.2.2704812 |url=}}</ref><ref name="pmid945331">{{cite journal |vauthors=Perks WH, Cross JN, Sivapragasam S, Johnson P |title=Supratentorial haemangioblastoma with polycythaemia |journal=J. Neurol. Neurosurg. Psychiatry |volume=39 |issue=3 |pages=218–20 |date=March 1976 |pmid=945331 |doi= |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Infratentorial]]
| |
| | |
| * [[Cyst|Cystic]] lesion with a solid enhancing mural [[nodule]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Blood vessel]] origin
| |
| | |
| * [[Capillary|Capillaries]] with thin walls
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Might secret [[erythropoietin]] and cause [[polycythemia]]
| |
| * May be associated with [[Von Hippel-Lindau Disease|von hippel-lindau syndrome]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pituitary adenoma]]<br><ref name="pmid3786729">{{cite journal |vauthors=Kucharczyk W, Davis DO, Kelly WM, Sze G, Norman D, Newton TH |title=Pituitary adenomas: high-resolution MR imaging at 1.5 T |journal=Radiology |volume=161 |issue=3 |pages=761–5 |date=December 1986 |pmid=3786729 |doi=10.1148/radiology.161.3.3786729 |url=}}</ref><ref name="pmid22584705">{{cite journal |vauthors=Syro LV, Scheithauer BW, Kovacs K, Toledo RA, Londoño FJ, Ortiz LD, Rotondo F, Horvath E, Uribe H |title=Pituitary tumors in patients with MEN1 syndrome |journal=Clinics (Sao Paulo) |volume=67 Suppl 1 |issue= |pages=43–8 |date=2012 |pmid=22584705 |pmc=3328811 |doi= |url=}}</ref><ref name=":0" />
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | + [[Bitemporal hemianopia]]
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Endocrine]] abnormalities as a result of [[Pituitary adenoma|functional adenomas]] or pressure effect of non-functional [[Adenoma|adenomas]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Isointense to normal [[pituitary gland]] in T1
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Endocrine]] cell [[hyperplasia]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It is associated with [[MEN1]] disease.
| |
| | |
| * Initialy presents with upper bitemporal quadrantanopsia followed by [[Bitemporal hemianopia|bitemporal hemianopsia]] (pressure on [[Optic chiasm|optic chiasma]] from below)
| |
| | |
| *
| |
| | |
| *
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Schwannoma]]<br><ref name="DonnellyDaly2007">{{cite journal|last1=Donnelly|first1=Martin J.|last2=Daly|first2=Carmel A.|last3=Briggs|first3=Robert J. S.|title=MR imaging features of an intracochlear acoustic schwannoma|journal=The Journal of Laryngology & Otology|volume=108|issue=12|year=2007|issn=0022-2151|doi=10.1017/S0022215100129056}}</ref><ref name="pmid9639114">{{cite journal |vauthors=Feany MB, Anthony DC, Fletcher CD |title=Nerve sheath tumours with hybrid features of neurofibroma and schwannoma: a conceptual challenge |journal=Histopathology |volume=32 |issue=5 |pages=405–10 |date=May 1998 |pmid=9639114 |doi= |url=}}</ref><ref name="pmid28710469">{{cite journal |vauthors=Chen H, Xue L, Wang H, Wang Z, Wu H |title=Differential NF2 Gene Status in Sporadic Vestibular Schwannomas and its Prognostic Impact on Tumour Growth Patterns |journal=Sci Rep |volume=7 |issue=1 |pages=5470 |date=July 2017 |pmid=28710469 |doi=10.1038/s41598-017-05769-0 |url=}}</ref><ref name="HardellHansson Mild2003">{{cite journal|last1=Hardell|first1=Lennart|last2=Hansson Mild|first2=Kjell|last3=Sandström|first3=Monica|last4=Carlberg|first4=Michael|last5=Hallquist|first5=Arne|last6=Påhlson|first6=Anneli|title=Vestibular Schwannoma, Tinnitus and Cellular Telephones|journal=Neuroepidemiology|volume=22|issue=2|year=2003|pages=124–129|issn=0251-5350|doi=10.1159/000068745}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Split-fat sign
| |
| * Fascicular sign
| |
| * Often have areas of [[hemosiderin]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Schwann cell]] origin
| |
| | |
| * S100+
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It causes [[hearing loss]] and [[tinnitus]]
| |
| | |
| * May be associated with [[Neurofibromatosis type II|NF-2]] (bilateral [[Schwannoma|schwannomas]])
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Primary central nervous system lymphoma|Primary CNS lymphoma]]<br><ref name="pmid7480733">{{cite journal |vauthors=Chinn RJ, Wilkinson ID, Hall-Craggs MA, Paley MN, Miller RF, Kendall BE, Newman SP, Harrison MJ |title=Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectroscopy |journal=Radiology |volume=197 |issue=3 |pages=649–54 |date=December 1995 |pmid=7480733 |doi=10.1148/radiology.197.3.7480733 |url=}}</ref><ref name="Paulus19992">{{cite journal|last1=Paulus|first1=Werner|journal=Journal of Neuro-Oncology|title=Classification, Pathogenesis and Molecular Pathology of Primary CNS Lymphomas|volume=43|issue=3|year=1999|pages=203–208|issn=0167594X|doi=10.1023/A:1006242116122}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Usually deep in the [[white matter]]
| |
| | |
| * Single [[mass]] with ring enhancement
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[B cell]] origin
| |
| | |
| * Similar to [[Non-Hodgkin lymphoma|non hodgkin lymphoma]] ([[Diffuse large B cell lymphoma|diffuse large B cell]])
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Biopsy]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Usually in young [[immunocompromised]] patients ([[HIV]]) or old [[immunocompetent]] person.
| |
|
| |
|
| *
| |
| |-
| |
| | rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Vascular
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation|AV malformation]]<br><ref name="KucharczykLemme-Pleghos1985">{{cite journal|last1=Kucharczyk|first1=W|last2=Lemme-Pleghos|first2=L|last3=Uske|first3=A|last4=Brant-Zawadzki|first4=M|last5=Dooms|first5=G|last6=Norman|first6=D|title=Intracranial vascular malformations: MR and CT imaging.|journal=Radiology|volume=156|issue=2|year=1985|pages=383–389|issn=0033-8419|doi=10.1148/radiology.156.2.4011900}}</ref><ref name="FleetwoodSteinberg2002">{{cite journal|last1=Fleetwood|first1=Ian G|last2=Steinberg|first2=Gary K|title=Arteriovenous malformations|journal=The Lancet|volume=359|issue=9309|year=2002|pages=863–873|issn=01406736|doi=10.1016/S0140-6736(02)07946-1}}</ref><ref name=":0" />
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Supratentorial]]: ~85%
| |
| * Flow voids on T2 weighted images
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We do not perform [[biopsy]] for [[AVM]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Angiography]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We may see bag of worms appearance in [[CT angiography]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain aneurysm]]<br><ref name="ChapmanRubinstein1992">{{cite journal|last1=Chapman|first1=Arlene B.|last2=Rubinstein|first2=David|last3=Hughes|first3=Richard|last4=Stears|first4=John C.|last5=Earnest|first5=Michael P.|last6=Johnson|first6=Ann M.|last7=Gabow|first7=Patricia A.|last8=Kaehny|first8=William D.|title=Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease|journal=New England Journal of Medicine|volume=327|issue=13|year=1992|pages=916–920|issn=0028-4793|doi=10.1056/NEJM199209243271303}}</ref><ref name="pmid25632331">{{cite journal |vauthors=Castori M, Voermans NC |title=Neurological manifestations of Ehlers-Danlos syndrome(s): A review |journal=Iran J Neurol |volume=13 |issue=4 |pages=190–208 |date=October 2014 |pmid=25632331 |pmc=4300794 |doi= |url=}}</ref><ref name="SchievinkRaissi2010">{{cite journal|last1=Schievink|first1=W. I.|last2=Raissi|first2=S. S.|last3=Maya|first3=M. M.|last4=Velebir|first4=A.|title=Screening for intracranial aneurysms in patients with bicuspid aortic valve|journal=Neurology|volume=74|issue=18|year=2010|pages=1430–1433|issn=0028-3878|doi=10.1212/WNL.0b013e3181dc1acf}}</ref><ref name="pmid28486967">{{cite journal |vauthors=Germain DP |title=Pseudoxanthoma elasticum |journal=Orphanet J Rare Dis |volume=12 |issue=1 |pages=85 |date=May 2017 |pmid=28486967 |pmc=5424392 |doi=10.1186/s13023-017-0639-8 |url=}}</ref><ref name="pmid27162847">{{cite journal |vauthors=Farahmand M, Farahangiz S, Yadollahi M |title=Diagnostic Accuracy of Magnetic Resonance Angiography for Detection of Intracranial Aneurysms in Patients with Acute Subarachnoid Hemorrhage; A Comparison to Digital Subtraction Angiography |journal=Bull Emerg Trauma |volume=1 |issue=4 |pages=147–51 |date=October 2013 |pmid=27162847 |pmc=4789449 |doi= |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * In [[magnetic resonance angiography]], we may see [[aneurysm]] mostly in anterior circulation (~85%)
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We do not perform [[biopsy]] for [[brain aneurysm]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Magnetic resonance angiography]] and [[CT angiography]] ([[Angiography]] is reserved for patients who have negative [[Magnetic resonance angiography|MAR]] and [[CT angiography|CTA]])
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It is associated with [[autosomal dominant polycystic kidney disease]], [[Ehlers-Danlos syndrome]], [[pseudoxanthoma elasticum]] and [[Bicuspid aortic valve]]
| |
| |-
| |
| | rowspan="6" style="background: #DCDCDC; padding: 5px; text-align: center;" |Infectious
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Bacterial [[brain abscess]]<br><ref name="HaimesZimmerman1989">{{cite journal|last1=Haimes|first1=AB|last2=Zimmerman|first2=RD|last3=Morgello|first3=S|last4=Weingarten|first4=K|last5=Becker|first5=RD|last6=Jennis|first6=R|last7=Deck|first7=MD|title=MR imaging of brain abscesses|journal=American Journal of Roentgenology|volume=152|issue=5|year=1989|pages=1073–1085|issn=0361-803X|doi=10.2214/ajr.152.5.1073}}</ref><ref name="BrouwerTunkel2014">{{cite journal|last1=Brouwer|first1=Matthijs C.|last2=Tunkel|first2=Allan R.|last3=McKhann|first3=Guy M.|last4=van de Beek|first4=Diederik|title=Brain Abscess|journal=New England Journal of Medicine|volume=371|issue=5|year=2014|pages=447–456|issn=0028-4793|doi=10.1056/NEJMra1301635}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Leukocytosis]]
| |
| * Elevated [[ESR]]
| |
| * [[Blood culture]] may be positive for underlying [[organism]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Central hypodense signal and surrounding ring-enhancement in T1
| |
| * Central hyperintense area surrounded by a well-defined hypointense capsule with surrounding [[edema]] in T2
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We do not perform [[biopsy]] for [[brain abscess]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Clinical presentation/ imaging
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * The most common causes of [[brain abscess]] are [[Streptococcus]] and [[Staphylococcus]].
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tuberculosis]]<br><ref name="MorgadoRuivo2005">{{cite journal|last1=Morgado|first1=Carlos|last2=Ruivo|first2=Nuno|title=Imaging meningo-encephalic tuberculosis|journal=European Journal of Radiology|volume=55|issue=2|year=2005|pages=188–192|issn=0720048X|doi=10.1016/j.ejrad.2005.04.017}}</ref><ref name=":0" /><ref name="pmid19275620">{{cite journal |vauthors=Be NA, Kim KS, Bishai WR, Jain SK |title=Pathogenesis of central nervous system tuberculosis |journal=Curr. Mol. Med. |volume=9 |issue=2 |pages=94–9 |date=March 2009 |pmid=19275620 |pmc=4486069 |doi= |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Positive [[acid-fast bacilli]] ([[AFB]]) smear in [[CSF]] specimen
| |
| * Positive [[CSF]] [[nucleic acid]] amplification testing
| |
| * [[Hyponatremia]] (inappropriate secretion of [[antidiuretic hormone]])
| |
| * Mild [[anemia]]
| |
| * [[Leukocytosis]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Hydrocephalus]] combined with marked basilar [[Meninges|meningeal]] enhancement
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We do not perform [[biopsy]] for [[brain]] [[tuberculosis]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[CSF]] analysis/ Imaging
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It is associated with [[HIV]] [[infection]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Toxoplasmosis]]<br><ref name="pmid74807332">{{cite journal |vauthors=Chinn RJ, Wilkinson ID, Hall-Craggs MA, Paley MN, Miller RF, Kendall BE, Newman SP, Harrison MJ |title=Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectroscopy |journal=Radiology |volume=197 |issue=3 |pages=649–54 |date=December 1995 |pmid=7480733 |doi=10.1148/radiology.197.3.7480733 |url=}}</ref><ref name="pmid27348541">{{cite journal |vauthors=Helton KJ, Maron G, Mamcarz E, Leventaki V, Patay Z, Sadighi Z |title=Unusual magnetic resonance imaging presentation of post-BMT cerebral toxoplasmosis masquerading as meningoencephalitis and ventriculitis |journal=Bone Marrow Transplant. |volume=51 |issue=11 |pages=1533–1536 |date=November 2016 |pmid=27348541 |doi=10.1038/bmt.2016.168 |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Normal [[CSF]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Multifocal [[Mass|masses]] with ring enhancement
| |
| * Mostly in [[basal ganglia]], [[thalami]], and corticomedullary junction.
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We do not perform [[biopsy]] for brain [[toxoplasmosis]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Clinical presentation/ imaging
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It is associated with [[HIV]] [[infection]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hydatid cyst]]<br><ref name="pmid27620198">{{cite journal |vauthors=Taslakian B, Darwish H |title=Intracranial hydatid cyst: imaging findings of a rare disease |journal=BMJ Case Rep |volume=2016 |issue= |pages= |date=September 2016 |pmid=27620198 |pmc=5030532 |doi=10.1136/bcr-2016-216570 |url=}}</ref><ref name=":0" />
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: left;" |
| |
| * Positive [[serology]] ([[Antibody]] detection for [[E. granulosus]]'')''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Honeycomb appearance
| |
| * [[Necrotic]] area
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We do not perform [[biopsy]] for [[Hydatid cyst|hydatid cysts]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Imaging
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Brain]], [[eye]], and [[Spleen|splenic]] [[Cyst|cysts]] may not produce detectable amount of [[antibodies]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[CNS]] [[cryptococcosis]]<br><ref name="pmid25006721">{{cite journal |vauthors=McCarthy M, Rosengart A, Schuetz AN, Kontoyiannis DP, Walsh TJ |title=Mold infections of the central nervous system |journal=N. Engl. J. Med. |volume=371 |issue=2 |pages=150–60 |date=July 2014 |pmid=25006721 |pmc=4840461 |doi=10.1056/NEJMra1216008 |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Positive [[CSF]] [[antigen]] testing ([[coccidioidomycosis]])
| |
| * [[CSF]] [[Lymphocyte|lymphocytic]] [[pleocytosis]]
| |
| * Elevated [[CSF]] [[Protein|proteins]] and [[lactate]]
| |
| * Low [[CSF]] [[glucose]]
| |
| *
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Dilated peri[[vascular]] spaces
| |
| * [[Basal ganglia]] [[Pseudocyst|pseudocysts]]
| |
|
| |
| * Soap bubble brain lesions ([[cryptococcus neoformans]])
| |
| *
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We may see numerous acutely branching septate [[Hypha|hyphae]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Laboratory|Lab]] data/ Imaging
| |
| * since [[brain]] [[Biopsy|biopsies]] are highly invasive and may may cause [[neurological]] deficits, we [[diagnose]] [[CNS]] [[fungal]] [[Infection|infections]] based on [[laboratory]] and imaging findings
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It is the most common [[brain]] [[fungal infection]]
| |
|
| |
| * It is associated with [[HIV]], [[Immunosuppressive therapy|immunosuppressive therapies]], and [[Organ transplant|organ transplants]]
| |
| * In may happen in [[immunocompetent]] patients undergoing invasive procedures ( [[neurosurgery]]) or exposed to [[Contamination|contaminated]] devices or [[drugs]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[CNS]] [[aspergillosis]]<br><ref name="pmid250067212">{{cite journal |vauthors=McCarthy M, Rosengart A, Schuetz AN, Kontoyiannis DP, Walsh TJ |title=Mold infections of the central nervous system |journal=N. Engl. J. Med. |volume=371 |issue=2 |pages=150–60 |date=July 2014 |pmid=25006721 |pmc=4840461 |doi=10.1056/NEJMra1216008 |url=}}</ref>
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Positive [[galactomannan]] [[antigen]] testing ([[aspergillosis]])
| |
| * [[CSF]] [[Lymphocyte|lymphocytic]] [[pleocytosis]]
| |
| * Elevated [[CSF]] [[Protein|proteins]] and [[lactate]]
| |
| * Low [[CSF]] [[glucose]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Multiple [[Abscess|abscesses]]
| |
| * Ring enhancement
| |
| * Peripheral low signal intensity on T2
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * We may see numerous acutely branching septate [[Hypha|hyphae]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Laboratory|Lab]] data/ Imaging
| |
| * since [[brain]] [[Biopsy|biopsies]] are highly invasive and may may cause [[neurological]] deficits, we [[diagnose]] [[CNS]] [[fungal]] [[Infection|infections]] based on [[laboratory]] and imaging findings
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It is associated with [[HIV]], [[Immunosuppressive therapy|immunosuppressive therapies]], and [[Organ transplant|organ transplants]]
| |
| * In may happen in [[immunocompetent]] patients undergoing invasive procedures ( [[neurosurgery]]) or exposed to [[Contamination|contaminated]] devices or [[drugs]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Other
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain metastasis]]<br><ref name="pmid29307364">{{cite journal |vauthors=Pope WB |title=Brain metastases: neuroimaging |journal=Handb Clin Neurol |volume=149 |issue= |pages=89–112 |date=2018 |pmid=29307364 |pmc=6118134 |doi=10.1016/B978-0-12-811161-1.00007-4 |url=}}</ref><ref name=":0" />
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Multiple [[Lesion|lesions]]
| |
| * [[Vasogenic edema]]
| |
| *
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Based on the primary [[cancer]] type we may have different immunohistopathology findings.
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * History/ imaging
| |
| * If there is any uncertainty about [[etiology]], [[biopsy]] should be performed
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Most common primary [[Tumor|tumors]] that [[metastasis]] to [[brain]]:
| |
| ** [[Lung cancer]]
| |
| ** [[Renal cell carcinoma]]
| |
| ** [[Breast cancer]]
| |
| ** [[Melanoma]]
| |
| ** [[Gastrointestinal tract]]
| |
| |}
| |
| '''ABBREVIATIONS'''
| |
|
| |
| CNS=Central nervous system, AV=Arteriovenous, CSF=Cerebrospinal fluid, NF-2=Neurofibromatosis type 2, MEN-1=Multiple endocrine neoplasia, GFAP=Glial fibrillary acidic protein, HIV=Human immunodeficiency virus, BhCG=Human chorionic gonadotropin, ESR=Erythrocyte sedimentation rate, AFB=Acid fast bacilli
| |
|
| |
| ==References==
| |
| {{Reflist|2}} | | {{Reflist|2}} |
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|
| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |
| | [[CME Category::Cardiology]] |
|
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|
| | [[Category:Congenital disorders]] |
| | [[Category:Cardiology]] |
| | [[Category:Neurology]] |
| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Neurology]] | | [[Category:Needs content]] |
| [[Category:Neurosurgery]]
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| [[Category:Pathology]]
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| [[Category:Up-To-Date]]
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| [[Category:Oncology]]
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| [[Category:Medicine]]
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