Free-living amoebae are known to cause fatal granulomatous encephalitis in immunocompromised indi... more Free-living amoebae are known to cause fatal granulomatous encephalitis in immunocompromised individuals. They are also known to present as multifocal parenchymal lesions, pseudotumoral lesions, meningeal exudates, hemorrhagic infarcts, and necrosis in the brain. However, Acanthamoeba infection in an intracranial ependymal cyst has not been reported in the literature.A 25-year-old immunocompetent man presented with a suspected interhemispheric arachnoid cyst. The cyst fluid turned out be infected with Acanthamoeba. The patient was treated successfully with decompression of the cyst with combination chemotherapy.Acanthamoeba may cause secondary infection in an underlying brain cyst. A suspicion of such an infection must be raised in the presence of altered nature of CSF consistency. The aggressive chemotherapy is the only hope for favorable outcome. The dilemmas associated with the diagnosis and treatment are further discussed.
We present a case of prepontine-suprasellar tuberculoma involving the premamillary region of the ... more We present a case of prepontine-suprasellar tuberculoma involving the premamillary region of the third ventricular floor, a site suitable to perform an endoscopic third ventriculostomy (ETV) stoma, managed endoscopically, and discuss our findings. A 5-year-old male child was admitted in an unconscious state with a history of gradually progressive symptoms of raised intracranial pressure and low-grade fever for the last 3 months. Head computed tomography showed thick enhancing basal exudates, a prepontine-suprasellar ring-enhancing lesion with consequent obstructive hydrocephalus. The child was subjected to urgent endoscopy which revealed multiple ependymal tubercles along with prepontine-suprasellar tuberculoma involving the premamillary region of the third ventricular floor. The tuberculoma was decompressed using a 5-french catheter, and ETV was performed. Postoperatively, the child improved clinicoradiologically on antitubercular chemotherapy and needed no further cerebrospinal fluid diversion surgery; he is under regular follow-up. We conclude that ETV may be attempted even in the presence of thick basal exudates and/or prepontine-suprasellar tuberculoma.
Free-living amoebae are known to cause fatal granulomatous encephalitis in immunocompromised indi... more Free-living amoebae are known to cause fatal granulomatous encephalitis in immunocompromised individuals. They are also known to present as multifocal parenchymal lesions, pseudotumoral lesions, meningeal exudates, hemorrhagic infarcts, and necrosis in the brain. However, Acanthamoeba infection in an intracranial ependymal cyst has not been reported in the literature.A 25-year-old immunocompetent man presented with a suspected interhemispheric arachnoid cyst. The cyst fluid turned out be infected with Acanthamoeba. The patient was treated successfully with decompression of the cyst with combination chemotherapy.Acanthamoeba may cause secondary infection in an underlying brain cyst. A suspicion of such an infection must be raised in the presence of altered nature of CSF consistency. The aggressive chemotherapy is the only hope for favorable outcome. The dilemmas associated with the diagnosis and treatment are further discussed.
We present a case of prepontine-suprasellar tuberculoma involving the premamillary region of the ... more We present a case of prepontine-suprasellar tuberculoma involving the premamillary region of the third ventricular floor, a site suitable to perform an endoscopic third ventriculostomy (ETV) stoma, managed endoscopically, and discuss our findings. A 5-year-old male child was admitted in an unconscious state with a history of gradually progressive symptoms of raised intracranial pressure and low-grade fever for the last 3 months. Head computed tomography showed thick enhancing basal exudates, a prepontine-suprasellar ring-enhancing lesion with consequent obstructive hydrocephalus. The child was subjected to urgent endoscopy which revealed multiple ependymal tubercles along with prepontine-suprasellar tuberculoma involving the premamillary region of the third ventricular floor. The tuberculoma was decompressed using a 5-french catheter, and ETV was performed. Postoperatively, the child improved clinicoradiologically on antitubercular chemotherapy and needed no further cerebrospinal fluid diversion surgery; he is under regular follow-up. We conclude that ETV may be attempted even in the presence of thick basal exudates and/or prepontine-suprasellar tuberculoma.
Uploads
Papers