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Related Concept Videos

Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...

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Transient Middle Cerebral Artery Occlusion Model of Stroke
05:32

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Published on: August 11, 2023

Tumefactive Multiple Sclerosis presenting as Acute Ischemic Stroke.

Hussam A Yacoub1, Zaid A Al-Qudahl, Huey-Jen Lee

  • 1Department of Radiology, UMDNJ-New Jersey Medical School, Newark, NJ.

Journal of Vascular and Interventional Neurology
|April 21, 2012
PubMed
Summary
This summary is machine-generated.

Tumefactive multiple sclerosis (MS) can mimic other brain conditions. A brain biopsy confirmed MS in a patient misdiagnosed with stroke, highlighting its importance in challenging cases.

Keywords:
demyelinationmultiple sclerosisstroketumefactivetumor

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Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Multiple sclerosis (MS) lesions are typically small, homogenous ovoid lesions on MRI.
  • Atypical MS lesions can present with features like large size, mass effect, and edema.
  • Tumefactive MS lesions radiographically resemble neoplasms, infarction, and infections.

Purpose of the Study:

  • To present a case of tumefactive demyelinating lesion misdiagnosed as ischemic stroke.
  • To highlight the diagnostic challenges and the role of brain biopsy in tumefactive MS.

Main Methods:

  • Case report of a 43-year-old woman with right-gaze preference and left-sided weakness.
  • Diagnostic workup included laboratory tests, contrast-enhanced MRI, cerebrospinal fluid analysis, and magnetic resonance spectroscopy (MRS).
  • Brain biopsy was performed for definitive diagnosis.

Main Results:

  • MRI revealed FLAIR hyperintensity and restricted diffusion in the right frontal lobe.
  • MRS showed elevated choline/creatine, increased lactate, and normal NAA/creatine ratios.
  • Brain biopsy confirmed demyelination with axonal preservation and T-cell infiltration, indicative of active MS.

Conclusions:

  • Tumefactive MS can be misdiagnosed as stroke, infection, or tumor.
  • Brain biopsy is crucial for diagnosing atypical or challenging cases of tumefactive MS.