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Organizing hematoma in a child presenting as a 'doughnut lesion' on nuclear scan. Case report
Child'S Brain
|January 1, 1977
Insights
A child
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Neurosurgery
Background:
- Headaches and fever in children can indicate serious neurological conditions.
- Brain abscesses are a critical differential diagnosis in pediatric neurology.
Observation:
- A 4 1/2-year-old boy presented with persistent frontal headaches, fever, and a history of seizures.
- Clinical examination revealed papilledema, and neuroimaging showed a frontal mass with a characteristic 'doughnut' sign.
Findings:
- Surgical exploration revealed an encapsulated hematoma, not a brain abscess as initially suspected.
- Histological examination indicated the presence of underlying microangiomata as the cause.
Implications:
- This case highlights the importance of considering encapsulated hematomas in the differential diagnosis of pediatric brain masses.
- Microangiomata should be considered in the etiology of intracranial hematomas in children.
Abstract:
We report a 4 1/2-year-old boy who presented with a 4-week history of frontal headaches and fever, and generalized convulsion 5 months previously. Papilledema, an abnormal EEG and a brain scan with a frontal mass and 'doughnut' sign were found. The association of the clinical history with brain scan findings strongly suggested a brain abscess. At surgery the lesion proved to be an encapsulated hematoma; Histological findings suggest underlying microangiomata.