Erschienen in:
08.11.2019 | Clinical Case
Freiburg Neuropathology Case Conference
A Progressive Lesion of the Optic Tract, Brainstem, Hypothalamus and Basal Ganglia
verfasst von:
C. A. Taschner, S. Doostkam, P. C. Reinacher, H. Urbach, A. Rau, M. Prinz
Erschienen in:
Clinical Neuroradiology
|
Ausgabe 4/2019
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Excerpt
A 63-year-old male patient presented with a 6-month history of reduction in performance and fatigue as well as a change in character and for 3 months he had an additional deterioration in vigilance with an increasing imperative urge to sleep and a frontal disinhibition, which led to admission to psychiatry. Magnetic resonance imaging (MRI) revealed a suspicious lesion of the right optic tract and the hypothalamus (Figs.
1 and
2). A stereotactic biopsy in the area of the right hypothalamus above the optic tract was performed, revealing only small cell groups of B and T cells , which were considered non-specific; however, the patient had been under corticotherapy in the month prior to the biopsy and 2 months later the patient presented in a clinically stable condition and the corticotherapy had been discontinued. On MRI new lesions had occurred (Figs.
3 and
4) located bilaterally in the basal ganglia and a second stereotactic biopsy was performed targeting out a contrast-enhancing lesion in the left globus pallidus (Fig.
5). …
