Intraspinal Space-Occupying Lesions in Children: Clinical Features, Neuroimaging and Surgical Outcomes of 27 Cases (original) (raw)
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Imaging of Intracranial Space Occupying Lesions
International Journal of Medical and Biomedical Studies, 2021
Introduction: With advanced MRI techniques such as perfusion, diffusion, and spectroscopy, it is now possible to differentiate between various intracranial lesions. Materials and Methods: This prospective cohort study was conducted on 50 patients referred by various clinical departments with clinical suspicion of intracranial space occupying lesions, evaluated by computed tomography & magnetic resonance imaging. Result: Solitary lesions were present in 35 patients (70%) & multiple lesions in 15 patients (30%). 68.00% lesions were Supratentorial & 32.00% infratentorial in location. Most common supratentorial location in adults was frontal lobe 40% followed by parietal lobe 30%. Most common supratentorial locations in children were frontal lobe. Infratentorially, cerebellum & posterior fossa were found to be most common location in adults & children respectively. Supratentorial lesions were most common both in adults & children. 60% lesions were intraaxial & 40 % extra axial in locati...
A Study on Role of Magnetic Resonance Imaging (MRI) in Intracranial Space Occupying Lesions
National Journal of Medical Research, 2015
Background: The high morbidity and mortality associated with Intracranial Space Occupying Lesions necessitates their early diagnosis so as to plan the intervention that is required. In the present study cases of either clinically suspected brain space occupying lesions or already diagnosed cases of brain space occupying lesions were studied by cross sectional imaging of MRI. Methodology: The present cross-sectional study was conducted presented with symptoms of raised ICT of sub acute onset & had lateralizing sign. A semi-structured questionnaire was prepared and demographic and clinical data like age, sex, symptoms and various morphological characters of Supratentorial SOLs were studied. A clinico-radiological correlation and confirmation of Radiological diagnosis was done by biopsy/surgery/MRI whenever possible to minimize patient follow up. Results: Majority of the patients were in the fourth decade (28.5%). Metastases were the most common single group of intracranial space occupying lesion (27%), Gliomas were the most common brain tumors (31.4%). Of the Gliomas, astrocytomas accounted for (81.8%). Most common hemisphere to be involved was the parietal lobe (31.4%). Intra-axial involvement (78.58 %) was most common localization in present study. Edema was the most common associated MRI finding (74.3%). Conclusion: The diagnostic accuracy of MRI in evaluation of intracranial space occupying lesion was 98.57 %. MRI remains the first line investigation for diagnosing and evaluation Intracranial space occupying lesion with a reasonable degree of diagnostic accuracy and with the advent of newer modifications of MRI such as MR Spectroscopy, 3-Tesla MRI, and newer techniques like MR Perfusion.
Journal of Datta Meghe Institute of Medical Sciences University
Background: Tumors of Central Nervous System constitute approximately 2% of all malignancies. Cancers of the central nervous system (CNS) are considered to be among the most notorious of all cancers. Low-grade cns tumors have been found over time to progress to high grade tumors. CNS is a common site for metastasis from other organs. Due to newer techniques used in radio diagnosis and stereotactic biopsies, more & more CNS tumors are being diagnosed & are being operated upon. Aims and objectives: The objective of this article is to provide an overview of intracranial and intraspinal space occupying lesions at a single tertiary care referral center. The aim was to study incidence of various lesions in light of the WHO classification of tumours of the central nervous system, 2016 and to study relevant statistics.
IP innovative publication pvt ltd, 2020
Introduction: Intracranial space occupying lesion (ICSOL) are infective and non-infective conditions, which can infect and occupy space in brain parenchyma. These ICSOL produce characteristic symptom and signs. If these symptom and signs are identified at an early stage of disease, more than half of these ICSOL are amenable to treatment Objective: Our study was done to identify the incidence of ICSOL in our city, along with the various co factors such as the gender, age socioeconomic condition and other risk factors. We also determined the prognosis of various ICSOL and Materials and Methods: Patients admitted in RKDF Medical College and Hospital, Bhopal in the department of Medicine, Neurology and Neurosurgery department with history and clinical features suggestive of intracranial space occupying lesion. Results: The study sample size included 30 patients, Of the 30 patients studied, 17 were male and 13 were female patients. Infective ICSOL was found to be more common in young age, while non infective was more common in old age. Common infective(16) causes, were Neurocysticercosis, Tuberculoma, Toxoplasmosis and Brain abscess. Non infective ICSOL accounted for 14 cases. Common non infective ICSOl were Glioma meningioma had the second highest incidence. Conclusion: The prevalence of ICSOL was found to be around 0.01%. Infective SOL was found to be more common in males during second and third decade. While Non infective SOL was found to be more common in females during sixth and seventh decade. ICSOL were associated with features of raised ICT, seizure or focal neurological deficit.. Radiologically, they were characterized by multiple or single well circumscribed ring-enhancing lesion. Aims and Objectives: 1: To find out the prevalence of intracranial space occupying lesion (ICSOL) and different causes of intracranial space occupying lesion in RKDF Medical college hospital and research center Bhopal during one year period between 01/03/2018 - 28/02/2019. 2: To find out the clinical features and CT Scan features of various intracranial space occupying lesion and their correlation (CT/Clinical).
We describe clinical, diagnostic features and follow up of a patient with a vanishing brain lesion. A 14-year-old child admitted to the department of Neurology at September 2009 with a history of subacute onset of fever, anorexia, vomiting, blurring of vision and right hemiparesis since one month. Magnetic resonance imaging (MRI) of the brain revealed presence of intra-axial large mass (25 mm × 19 mm) in the left temporal lobe and the brainstem which showed hypointense signal in T1W and hyperintense signals in T2W and fluid attenuated inversion recovery (FLAIR) images and homogenously enhanced with gadolinium (Gd). It was surrounded by vasogenic edema with mass effect. Intravenous antibiotics, mannitol (2 g/12 h per 2 d) and dexamethasone (8 mg/12 h) were given to relief manifestations of increased intracranial pressure. Whole craniospinal radiotherapy (brain = 4000 CGy/20 settings per 4 wk; Spinal = 2600/13 settings per 3 wk) was given based on the high suspicion of neoplastic lesion (lymphoma or glioma). Marked clinical improvement (up to complete recovery) occurred within 15 d. Tapering of the steroid dose was done over the next 4 mo. Follow up with MRI after 3 mo showed small lesion in the left antero-medial temporal region with hypointense signal in T1W and hyperintense signals in T2W and FLAIR images but did not enhance with Gd. At August 2012, the patient developed recurrent generalized epilepsy. His electroencephalography showed the presence of left temporal focus of epileptic activity. MRI showed the same lesion as described in the follow up. The diffusion weighted images were normal. The seizures frequency was decreased with carbamazepine therapy (300 mg/12 h). At October 2014, single voxel proton (1H) MR spectroscopy (MRS) showed reduced N-acetyl-aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, NAA/Cho ratios consistent with absence of a neoplasm and highly suggested presence of gliosis. A solitary brain mass in a child poses a considerable diagnostic difficulty. MRS provided valuable diagnostic differentiation between tumor and pseudotumor lesions.
Zenodo (CERN European Organization for Nuclear Research), 2018
Background: Tumors of Central Nervous System constitute approximately 2% of all malignancies. Cancers of the central nervous system (CNS) are considered to be among the most notorious of all cancers. Low-grade cns tumors have been found over time to progress to high grade tumors. CNS is a common site for metastasis from other organs. Due to newer techniques used in radio diagnosis and stereotactic biopsies, more & more CNS tumors are being diagnosed & are being operated upon. Aims and objectives: The objective of this article is to provide an overview of intracranial and intraspinal space occupying lesions at a single tertiary care referral center. The aim was to study incidence of various lesions in light of the WHO classification of tumours of the central nervous system, 2016 and to study relevant statistics.
Incidental brain lesions in children: to treat or not to treat?
Journal of Neuro-Oncology, 2012
Central nervous system (CNS) lesions that are discovered incidentally when imaging children for problems that were unrelated to the detected lesion pose a dilemma to physicians. Because there are few data on the outcome of such cases, we retrospectively reviewed the clinical course of a group of children followed at our institution with brain lesions found incidentally on neuroimaging. A database of all children with brain lesions followed at the University of Rochester medical center from 2000 to 2010 was reviewed. Data were obtained regarding presentation, magnetic resonance imaging (MRI) features, treatment, progression-free survival, and overall survival of children with brain lesions found incidentally. Of the 244 children with brain lesions seen over this time period, 21 (8.6%) were found to have incidentally discovered brain lesions. Of these 21 children, 12 (57%) underwent surgical resection of their brain lesions. Ten patients (48%) had symptoms considered to be unassociated with the detected lesion. Lesions were found in the cerebellum (n = 7, 33%), midline (n = 5, 24%), and cerebrum (n = 9, 43%). All lesions were B5 cm in diameter. Eight patients (38%) had surgery at presentation, one because of imaging features suspicious for a posterior fossae ependymoma, and the seven others because of location in the posterior fossae or brain stem. Of the remaining 13 patients, five had progression of disease on serial MRI scans: four underwent surgery and the fifth was monitored and remained stable after the initial progression stabilized. Nine of the ten patients (90%) with posterior fossae lesions underwent surgery, while only three of 11 with supratentorial lesions underwent surgery (27%) (P = 0.006). The progression free survival was 94% at 12 months (95% CI 65-99%) and 71% at 24 months (95% CI 39-88%). At a median follow-up of 32 months, the overall survival was 100%. Incidentally detected CNS lesions are usually small. The outcome for children with such lesions is excellent. Close monitoring of these patients with serial MRIs may be a safe alternative to immediate biopsy and/or resection for select patients.
Computed Tomography Evaluation of Intracranial Space Occupying Lesions in Adults
2014
Introduction: Neoplasms of the brain present a remarkably diverse spectrum of growths. Computed tomography (CT) has now become the primary imaging modality for intracranial space occupying lesions (SOL) with effi cacy of 90-98%. Aim: The aims and objectives of this study are to know the frequency of occurrence of various intracranial SOL in adults and to analyze the CT brain scan data to determine the diagnostic sensitivity and specifi city of CT. Materials and Methods: A total of 100 cases of intracranial SOL were studied in patients above the age group of 18 years. Patients were followed up over a period of 2 years for histological co-relation. Data collected was analyzed with review of the literature. Results: This review has indicated that intracranial SOL often show characteristic features on CT that help in making a confi dent diagnosis. It is possible to attempt grading of the tumor with a fair degree of reliability. Conclusion: CT assessment supported by a sound understandin...
Clinical Pattern of Intra-cranial space occupying lesion in Tertiary Level Hospital
Journal of Dhaka Medical College, 2020
Background : The term “Intra-cranial space occupying lesion” (ICSOL) is defined as any neoplasm, benign or malignant, primary or secondary, as well as any inflammatory or parasitic mass lying within the cranial cavity. Advances in intracranial imaging have made the detection of intracranial lesions relatively accurate and enabling us to focus on the etiology of these space-occupying lesions. Many reports suggested that both incidence and pattern of intracranial space occupying lesions are subject to considerable geographic and racial variations. Knowledge of the regional peculiarities of these lesions will help in identifications of possible risk factors. Materials and Methods: This observational study was done in the department of medicine of Mymensingh medical college hospital, Bangladesh from November, 2011 to April, 2012 to evaluate the clinical pattern of ICSOL among the 75 adult admitted patients. Patient aged more than 15 years of either sex with symptoms and signs of ICSOL a...
Multislice Computed Tomographic Evaluation of Intracranial Space Occupying Lesions
Introduction: The term intracranial space occupying lesions includes lesions which expand in volume to displace normal neural structures. They give rise to the various symptoms like focal seizures, paralysis, features of raised intracranial tension and false localizing signs. AIMS & OBJECTIVES: To determine the role of computed tomography in evaluation of space occupying lesions of brain, assessment of the site, nature and extent, age and sex prevalence of space occupying lesions. MATERIAL & METHODS: The present study was conducted on one hundred patients with space occupying lesions of the brain presenting with various neurologic symptoms or incidental findings. Patients of all age groups suspected to have intracranial space occupying lesions were included in the study. Results were expressed as mean ± SD and proportions as percentages. Results: Most of the cases of hyperdense lesions were intracerebral hemorrhages, meningioma, lymphoma and medulloblastoma. High grade astrocytomas were heterogenous hypodense lesions with irregular ring enhancement associated perilesional edema and mass effect. Low grade astrocytomas had minimal rim/ mural nodule enhancement. Intracranial tuberculoma and neurocysticercosis showed ring with nodular enhancing. Calcification was seen in tuberous sclerosis, neurocysticercosis, meningiomas, oligodendrogliomas, arteriovenous malformations and dermoid cyst. Congenital lesions had variable presentation ranging from cystic to mixed pattern lesions. CONCLUSIONS: In developing countries, CT imaging remains as a major diagnostic modality, with easy accessibility and technical ease as compared to MRI.