TAILIEUCHUNG - Ebook Neuroradiology - Key differential diagnoses and clinical questions: Part 2

(BQ) Part 2 book "Neuroradiology - Key differential diagnoses and clinical questions" presents the following contents: Cyst with a mural nodule, ecchordosis physaliphora versus chordoma, atlantooccipital and atlantoaxial separation, basilar invagination and platybasia, enhancing intramedullary conus lesions, nerve root enlargement,. | Cyst with a Mural Nodule JUAN E. SMALL MD T1 Post T1 Post CASE A A 51-year-old man with a history of headaches for 6 weeks now presenting with dizziness and nausea. T1 Post T1 Post CASE B A 36-year-old Brazilian woman presenting with a 5-day history of progressive confusion paranoid delusions and magical thinking. 167 168 Brain and Coverings DESCRIPTION OF FINDINGS Case A A supratentorial right temporal cyst with an enhancing mural nodule. No edema or other lesions are noted. Case B An infratentorial right cerebellar cyst with an enhancing mural nodule. No edema or other lesions are noted. DIAGNOSIS Case A Ganglioglioma Case B Hemangioblastoma SUMMARY A number of lesions may present with the imaging appearance of a cyst with an enhancing mural nodule including hemangioblastoma pilocytic astrocytoma pleomorphic xanthoastrocytoma ganglioglioma neurocysticercosis and metastases. How then can this differential diagnosis be tailored in a useful way The location of the lesion coupled with the age of the patient can help narrow the differential diagnosis Tables 27-1 and 27-2 . The supratentorial or infratentorial position of the lesion statistically limits the considerations. Because the most common lesion in the posterior fossa in an adult patient is a metastasis an atypical appearance of a metastasis as a cyst with an enhancing mural nodule is an important consideration. TABLE 27-1 Location Posterior Fossa Pilocytic astrocytoma Hemangioblastoma Metastasis Temporal Lobe Ganglioglioma Pleomorphic xanthoastrocytoma TABLE 27-2 Patient Age Child and Adolescent Adult Pilocytic astrocytoma Hemangioblastoma Ganglioglioma Glioblastoma multiforme Pleomorphic xanthoastrocytoma Metastasis In addition the most common primary posterior fossa mass in an adult patient is a hemangioblastoma which is associated with von Hippel-Lindau disease. The presence of flow voids within the mural nodule suggests a highly vascular lesion such as a hemangioblastoma although highly vascular metastasis

• Y khoa - Dược
• Key differential diagnoses
• Clinical questions
• Ecchordosis physaliphora versus chordoma
• Atlantoaxial separation
• Basilar invagination
• Enhancing intramedullary conus lesions
• Nerve root enlargement
• Computed tomography hyperdense lesions
• T1 hyperintense lesions
• Multiple susceptibility artifact lesions
• Ring enhancing lesions