A: An axial CT scan on admission showed hydrocephalus and lipid-equivalent hypodense lesions (white arrows, −100 HU). B: Emergency axial CT scan obtained 7 days after admission displays decrease of hydrocephalus after insertion of a VP shunt and lipid-equivalent hypodense lesions (white arrow). Multiple infarctions are shown in the axial CT scan 10 days after admission (C). Global brain edema on the axial CT scan 17 days after admission (D).

Contexts in source publication

Context 1

... female was admitted to our institution due to headache and nausea. She had undergone previous resections, one in the early 1990s and another 16 years later, of a right temporomesial DC, with only subtotal removal of the DC due to its firm adhesions in both surgeries. The computed tomography (CT) scan on admission revealed a hydrocephalus (Fig. 1A) treated by the insertion of a VP shunt. The thorough investigation of the cerebrospinal fluid (CSF) showed no evidence of tumor cells or signs of aseptic or bacterial meningitis. Seven days after surgery, the patient presented with a facial palsy and dysphagia. Only 6 hours after the onset of symptoms, the patient deteriorated into ...

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... deteriorated into coma and had to be intubated and mechanically ventilated. The emergency axial nonenhanced CT scan displayed lipid-equivalent hypodense lesions in the right temporomesial region with residual marginal calcifications compatible with a dissemination of the DC, which retrospectively was already obvious on the CT scan at admission ( Fig. 1A and B). Additionally, the decrease in ventricular size indicated a proper function of the VP shunt (Fig. 1B). Cranial magnetic resonance imaging (MRI) revealed dural and ependymal enhancement with an increased diffusion-weighted imaging (DWI) signal in the basal ganglia on both sides and the right cerebellar vermis indicating ischemia. On ...

Context 3

... CT scan displayed lipid-equivalent hypodense lesions in the right temporomesial region with residual marginal calcifications compatible with a dissemination of the DC, which retrospectively was already obvious on the CT scan at admission ( Fig. 1A and B). Additionally, the decrease in ventricular size indicated a proper function of the VP shunt (Fig. 1B). Cranial magnetic resonance imaging (MRI) revealed dural and ependymal enhancement with an increased diffusion-weighted imaging (DWI) signal in the basal ganglia on both sides and the right cerebellar vermis indicating ischemia. On cranial MRI the DC showed a hyperintense T1 signal intensity without contrast enhancement, an iso-to ...

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... Furthermore, profuse leptomeningeal enhancement as a correlate of carcinomatous meningitis, progressive hydrocephalus and transependymal diapedesis of cerebrospinal fluid were encountered. Suspecting chemical meningitis as a complication of the DC, steroid medication was commenced. Follow-up CT scan after 3 days revealed multifocal infarctions (Fig. 1C). Unfortunately, the comatose patient developed fixed and dilated pupils after 10 days on the intensive care unit (ICU), and follow-up CT scan revealed global brain edema, which led to cerebral circulatory arrest (Fig. 1D). The patient died 60 days after initial admission for the hydrocephalus. At autopsy, cellular tumor invasion within ...

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... as a complication of the DC, steroid medication was commenced. Follow-up CT scan after 3 days revealed multifocal infarctions (Fig. 1C). Unfortunately, the comatose patient developed fixed and dilated pupils after 10 days on the intensive care unit (ICU), and follow-up CT scan revealed global brain edema, which led to cerebral circulatory arrest (Fig. 1D). The patient died 60 days after initial admission for the hydrocephalus. At autopsy, cellular tumor invasion within the abdomen and the VP shunt ( Fig. 3A and B) was found. Histopathological examination of the temporal tumor showed an infiltration of the trigeminal ganglion and perineural invasion by atypical squamous epithelium with ...