Coexistence of longitudinally extensive transverse myelitis and diffuse midline glioma in the brainstem in an adolescent boy with acute flaccid paralysis.

Autor: Caliskan E; Department of Pediatric Radiology, Kartal Dr. Lutfi Kirdar City Hospital, University of Health Sciences, D-100 Güney Yanyol, Cevizli Mevkii, No:47, 34865, Kartal, Istanbul, Turkey. eminecaliskanrad@gmail.com., Sager SG; Department of Pediatric Neurology, Kartal Dr. Lutfi Kirdar City Hospital, University of Health Sciences, D-100 Güney Yanyol, Cevizli Mevkii, No:47, 34865, Kartal, Istanbul, Turkey., Yukselmis U; Department of Pediatric Intensive Care, Kartal Dr. Lutfi Kirdar City Hospital, University of Health Sciences, D-100 Güney Yanyol, Cevizli Mevkii, No:47, 34865, Kartal, Istanbul, Turkey., Kilic AK; Department of Neurology, Kartal Dr. Lutfi Kirdar City Hospital, University of Health Sciences, D-100 Güney Yanyol, Cevizli Mevkii, No:47, 34865, Kartal, Istanbul, Turkey., Gunbey HP; Department Radiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, D-100 Güney Yanyol, Cevizli Mevkii, No:47, 34865, Kartal Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2024 Jan; Vol. 40 (1), pp. 227-232. Date of Electronic Publication: 2023 Sep 22.
DOI: 10.1007/s00381-023-06163-0
Abstrakt: We present the case of a previously healthy 13-year-old boy who was admitted to the emergency department with acute flaccid paralysis. Magnetic resonance imaging revealed radiological evidence of longitudinally extensive transverse myelitis. Additionally, homogeneous T2 signal increase was observed in the pons and medulla oblongata, initially indicating brainstem encephalitis. Subsequent evaluations confirmed a coexistence of diffuse midline glioma (DMG) in the brain stem alongside acute transverse myelitis (ATM). Children with ATM generally have a more favorable prognosis than adults. However, despite the implementation of advanced treatment methods, the patient's quadriplegia did not improve and resulted in spinal cord sequela atrophy. DMG exhibits an aggressive growth pattern and lacks a known curative treatment. This case represents an exceedingly rare synchronous occurrence of aggressive conditions, underscoring the importance of raising awareness among physicians. Furthermore, we aim to discuss the radiologic differential diagnosis, as this is the first documented instance in the literature.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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