Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Jun 1998
Case ReportsIdiopathic hypertrophic cranial pachymeningitis of the cavernous sinus mimicking lymphocytic hypophysitis.
A 56-year-old female presented with idiopathic hypertrophic cranial pachymeningitis manifesting as headache, hypopituitarism, and diabetes insipidus, mimicking lymphocytic hypophysitis. Five months later, she complained of double vision and unusual right facial sensation. The diagnosis was based on magnetic resonance imaging, angiography, and meningeal biopsy via transsphenoidal surgery, and exclusion of other know causes of pachymeningitis. ⋯ The clinical presentation of idiopathic hypertrophic cranial pachymeningitis is variable, and it may develop with signs of adjacent tissue involvement. Resultant secondary hypophysitis must be differentiated from lymphocytic hypophysitis. Initial steroid therapy is effective in improving symptoms, but should be carefully considered since the natural course of this disease seems to be self-limited.
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Neurol. Med. Chir. (Tokyo) · Jun 1998
Case ReportsClinical usefulness of 11C-MET PET and 201T1 SPECT for differentiation of recurrent glioma from radiation necrosis.
The clinical usefulness of L-methyl-11C-methionine positron emission tomography (11C-MET PET) and thallium-201 single photon emission computed tomography (201T1 SPECT) for distinguishing glioma recurrence from radiation-induced changes was evaluated. Ten patients with lesions highly suggestive of recurrent glioma on magnetic resonance imaging underwent 11C-MET PET and 201T1 SPECT studies. Two patients were examined twice, so a total of 12 studies were performed. ⋯ Four of the seven radiation necrosis lesions also appeared as increased uptakes on the 201T1 SPECT scans. In contrast, only one radiation necrosis appeared as increased uptake on the 11C-MET PET scans. There was no significant difference in 201T1 SPECT indices between radiation necrosis and tumor recurrence, but the ratio of the differential absorption ratio of tumor tissue to that of the homologous contralateral gray matter in PET of recurrent glioma was significantly higher than that of radiation necrosis. 11C-MET PET is superior to 201T1 SPECT for the differentiation of tumor recurrence from radiation necrosis and delineation of the extent of the tumor.