Full moon mesencephalon sign: a transient cytotoxic lesion in a hemodialysis patient with newly diagnosed atrial fibrillation and severe stenosis of the right vertebral artery.

Autor: Sassi C; Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität zu Berlin, Berlin Institute of Health, Berlin, Germany. celeste.sassi@charite.de.; Department of Neurology, Martin Gropius Hospital, Eberswalde, Germany. celeste.sassi@charite.de., Habermann S; Department of Neurology, Martin Gropius Hospital, Eberswalde, Germany., Coria MA; Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität zu Berlin, Berlin Institute of Health, Berlin, Germany., Grüger A; Department of Neurology, Martin Gropius Hospital, Eberswalde, Germany., Kola V; Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.; Department of Neurology, Martin Gropius Hospital, Eberswalde, Germany., Schmitt HM; Department of Neurology, Martin Gropius Hospital, Eberswalde, Germany.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2024 Dec 11. Date of Electronic Publication: 2024 Dec 11.
DOI: 10.1007/s10072-024-07926-6
Abstrakt: Brain cytotoxic edema is a neuroradiological sign secondary to variegate diseases ranging from migraine to fulminant Listeria rhombencephalitis. The tempestive identification of its underlying cause is vital for an effective treatment as any delay may be fatal. However, the lack of distinctive imaging biomarkers and the paucity of reports pose a significant challenge in its diagnosis and frequently lead to a misdiagnosis particularly with the more common acute ischemic stroke. Importantly, due to its rarity, mesencephalon midline cytotoxic lesion is likely to remain an underdiagnosed clinical phenomenon, especially if follow up MRI is not performed. Here we report a case of a central, midline, symmetric midbrain cytotoxic edema in a haemodialysis patient with diverse chronic progressive severe cardiovascular risk factors and a newly diagnosed atrial fibrillation. We expand the spectrum of neuroradiological hallmarks associated to terminal renal failure and report a full moon-like mesencephalon midline transient restricted diffusion as a reliable imaging biomarker for the prompt and accurate diagnosis of midbrain cytotoxic edema with the enormous potential of rapidly identifying and effectively treating its causative factors and timely reverse the associated symptomatic.
Competing Interests: Declarations. Ethical approval: This case report was performed according to the international ethical guidelines and followed our institutional ethical tenets. Conflict of interest: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: