• Journal of Korean Neurosurgical Society
• /
• v.45 no.1
• /
• pp.50-52
• /
• 2009

A 31-year-old man presented with dull headache and memory disturbance lasting for one week. Computed tomographic scans revealed acute hydrocephalus. The cerebrospinal fluid contained 53 leukocytes/$mm^3$, with a mononuclear preponderance and no erythrocytes. Magnetic resonance imaging revealed hydrocephalus and leptomeningeal enhancement. Magnetic resonance angiography and digital subtraction angiography showed supraclinoid occlusion of the right internal carotid artery, which resembled unilateral moyamoya disease. Neuroendoscopic biopsy of a lesion in the septum pellucidum revealed noncaseating granulomas, which was consistent with sarcoidosis. The patient was successfully managed with intravenous methylprednisolone and ventriculoperitoneal shunting. To our knowledge, this is the first case of moyamoya-like vasculopathy associated with neurosarcoidosis.

• Annals of Clinical Neurophysiology
• /
• v.7 no.1
• /
• pp.52-54
• /
• 2005

Tuberculous radiculomyelitis (TBRM) is a complication of tuberculous meningitis (TBM), which has been reported rarely in the modern medical literature. We describe a case of TBRM, which developed during the treatment of TBM. A 28-year-old man suddenly developed lower back pain, flaccid paraparesis, urinary incontinence, while the TBM was improving with the treatment at 9th day after admission. Spinal MRI revealed leptomeningeal enhancement along with thoracolumbar spinal canal, thickening of nerve roots, spinal meninges and intramedullary high signal lesion in T2 level.

• Clinical and Experimental Pediatrics
• /
• v.45 no.12
• /
• pp.1596-1600
• /
• 2002

A 23-month-old girl visited with chronic cough and her chest radiograph showed miliary tuberculosis. There was no neurological abnormality. But CSF findings showed WBC $22/mm^3$(lymphocyte 20%, neutrophil 80%) and positive result of polymease chain reaction(PCR) for M. tuberculosis. MR imaging showed multiple ring enhanced nodules and ovoid nonenhancing bright signal lesion on the cerebrum, cerebellar parenchyme, and left basal ganglia. Antituberculous chemotherapy was done and follow-up MR imaging was done after six months. One month after treatment, the number and size of nodules had decreased. Six months after treatment, the multiple enhanced nodules and leptomeningeal enhancement were not observed, and high signal intensity of genu portion of left internal capsule and posterior portion of putamen were decreased.

• Pediatric Infection and Vaccine
• /
• v.9 no.1
• /
• pp.117-121
• /
• 2002

Although the incidence of intracranial tuberculosis in children have been decreased with development of antituberculous therapy, mortality rate is still high as formerly if the diagnosis and treatment was not performed early. Authors report a case of a 5-month old male with multiple intracranial tuberculoma who have been accompanied by miliary tuberculosis and tuberculous meningitis. He was hospitalized at the pediatric department of Wonkwang University Hospital with mild fever and persistent cough. The brain MRI was performed and showed that there were multiple intracranial micronodular densities, perinodular edema and diffuse leptomeningeal enhancement which were disappeared completely after antituberculosis chemotherapy for 12 months and he had completely recovered without sequale.

• Journal of the Korean Society of Radiology
• /
• v.81 no.2
• /
• pp.453-458
• /
• 2020

Hashimoto's encephalopathy (HE) is a rare autoimmune disease characterized by a high serum concentration of antithyroid antibodies without evidence of cerebral disease. Magnetic resonance imaging (MRI) findings in HE patients are nonspecific, although diffuse or focal white matter changes have been reported in several cases. We present a rare case involving a 79-year-old woman with elevated antithyroid antibody levels and abnormal imaging findings similar to meningoencephalitis. Serial MRI initially showed multiple T2 hyperintense lesions with diffuse leptomeningeal enhancement that disappeared after steroid therapy.

• Clinical and Experimental Pediatrics
• /
• v.61 no.8
• /
• pp.245-252
• /
• 2018

Purpose: This study investigated patterns of ischemic injury observed in brain images from patients with neonatal group B Streptococcal (GBS) meningitis. Methods: Clinical findings and brain images from eight term or near-term newborn infants with GBS meningitis were reviewed. Results: GBS meningitis was confirmed in all 8 infants via cerebrospinal fluid (CSF) analysis, and patients tested positive for GBS in both blood and CSF cultures. Six infants (75.0%) showed early onset manifestation of the disease (<7 days); the remaining 2 (25.0%) showed late onset manifestation. In 6 infants (75%), cranial ultrasonography showed focal or diffuse echogenicity, suggesting hypoxic-ischemic injury in the basal ganglia, cerebral hemispheres, and periventricular or subcortical white matter; these findings are compatible with meningitis. Findings from magnetic resonance imaging (MRI) were compatible with bacterial meningitis, showing prominent leptomeningeal enhancement, a widening echogenic interhemisphere, and ventricular wall thickening in all infants. Restrictive ischemic lesions observed through diffusion-weighted imaging were evident in all eight infants. Patterns of ischemic injury as detected through MRI were subdivided into 3 groups: 3 infants (37.5%) predominantly showed multiple punctuate lesions in the basal ganglia, 2 infants (25.0%) showed focal or diffuse cerebral infarcts, and 3 infants (37.5%) predominantly showed focal subcortical or periventricular white matter lesions. Four infants (50%) showed significant developmental delay or cerebral palsy. Conclusion: Certain patterns of ischemic injury are commonly recognized in brain images from patients with neonatal GBS meningitis, and this ischemic complication may modify disease processes and contribute to poor neurologic outcomes.

• Pediatric Infection and Vaccine
• /
• v.25 no.3
• /
• pp.113-122
• /
• 2018

Purpose: The aim of this study was to evaluate the clinical characteristics of children diagnosed as cryopyrin-associated periodic syndrome (CAPS) in Korea. Methods: Diagnosis was made based on clinical features and confirmed by a mutation in the cold-induced autoinflammatory syndrome 1 (CIAS1) gene. Especially, osteocartilaginous overgrowth in the patella or distal femur was so characteristic that its presence warranted a diagnosis of chronic infantile neurologic cutaneous and articular/NOMID. Results: We observed the clinical features of 9 Korean CAPS patients. All the patients suffered from an urticarial rash with recurrent fever. Among the 9 patients, 6 presented with rash and 4 with fever on the 1st or 2nd days of birth. Eight patients showed myalgia, and 7 patients showed arthralgia in the joints, and 6 patients showed radiologic findings of arthropathy including cupping of the metaphysis, excessive growth of the epiphysis, osteopenia or overgrowth of the cartilage. Four patients showed brain atrophy, enlarged ventricles or leptomeningeal enhancement on magnetic resonance imaging. Intellectual disability was observed in 1 patient. Five patients had eye involvement as conjunctivitis, uveitis, chorioretinitis, avascular area or papillary edema, and 3 patients showed progressive hearing loss. All 9 patients showed increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Conclusions: All the patients carried a mutation on exon 3 of the CIAS1 gene. After the anakinra (interleukin-1 receptor antagonist) therapy, the fever and rash immediately disappeared, and CRP and ESR were improved.