A 41-year-old man left for Mexico in May 2015. Right pulmonary nodule was detected at a health examination in May 2016, and he subsequently showed headache and slight fever. Contrast-enhanced magnetic resonance imaging of the brain revealed basilar meningitis, so he was admitted to our hospital. We considered imported mycosis due to his travel history to Mexico. We diagnosed histoplasmosis based on the presence of antibodies against Histoplasma in both serum and cerebrospinal fluid. Symptoms almost completely recovered with a liposomal formulation of amphotericin B. Central nervous system histoplasmosis is very rare in Japan. Immunocompetent hosts can develop histoplasmosis, and this pathology is important to consider in patients presenting with basilar meningitis and a positive travel history.
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http://dx.doi.org/10.5692/clinicalneurol.cn-001136 | DOI Listing |
Neurosarcoidosis, particularly in the absence of extra-neurologic systemic manifestations of sarcoidosis, is a challenging diagnosis that has a wide array of presentations. Most often presenting with cranial neuropathies, basilar meningitis or pituitary/hypothalamic dysfunction, isolated involvement of the spinal cord without cranial manifestations is exceptionally rare, often involving intramedullary lesions. Here, we present the unique case of a 64-year-old female with atypical neurosarcoidosis presenting with myelopathy from extra-dural nodules without other neurologic or systemic symptoms.
View Article and Find Full Text PDFIJID Reg
December 2024
Infectious Diseases Department, Ibn Rochd University Hospital Center, Faculty of Medicine and Pharmacy, HASSAN II University of Casablanca, Casablanca, Morocco.
We report a case of tuberculous meningitis without pleocytosis of the cerebrospinal fluid (CSF) in a 27-year-old patient admitted for a meningeal syndrome with signs of basilar involvement and an infectious syndrome associated with a hacking cough with whitish sputum and night sweats, evolving for 15 days before her admission, in a context of weight loss of 2 kg, asthenia, and anorexia. Cytobacteriological and chemical analysis of the CSF revealed less than 3 cells/mm white blood cells, high protein levels of 2.54 g/l, and low glucose levels of 0.
View Article and Find Full Text PDFActa Neurochir Suppl
November 2024
Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
The occipitocervical junction is formed by the foramen magnum (FM) and the adjacent anatomical structures of the C1 and C2 vertebrae. The FM is formed anteriorly by the basilar part of occipital bone. Anterolaterally, it borders the occipital condyles and hypoglossal canal as well as the jugular foramen.
View Article and Find Full Text PDFChilds Nerv Syst
December 2024
Department of Neuroimaging & Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.
Posterior fossa congenital pial arteriovenous fistulas are rare vascular anomalies associated with high morbidity. These anomalies often present challenges to neurointerventionists due to their complex morphological features. We successfully treated two technically challenging, infratentorial large pial arteriovenous fistulas (AVFs) associated with complete flow steal in the basilar artery.
View Article and Find Full Text PDFCureus
September 2024
Vascular and Endovascular Surgery, Vascular Surgery Clinic, Institute for Cardiovascular Diseases "Dedinje", Belgrade, SRB.
We present a case of a rare vascular variation of the persistent hypoglossal artery (PHA) in a 57-year-old Caucasian female patient with a medical history of poorly controlled hypertension, headaches, diabetes mellitus, and depression. This anatomical variation was initially misdiagnosed as an internal carotid artery (ICA) aneurysm during the extracranial carotid Doppler imaging conducted due to nonspecific symptoms of cerebrovascular insufficiency, manifesting as coordination disturbances. PHA is one of the four vertebrobasilar anastomoses, originating from the cervical segment of the ICA.
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