Findings
There is a well-defined lesion in the left cerebellar hemisphere, slightly hypointense to the brain parenchyma on T1-weighted images and slightly hyperintense on the T2 sequence (Figure 1 and Figure 2). Cerebellar folia are clearly demonstrated coursing through the lesion. There is no mass effect or surrounding edema. Minimal enhancement is seen on postcontrast administration (Figure 5).
The lesion is bright on diffusion-weighted images as well as on the ADC map (Figure 6 and Figure 7).
Diagnosis: Lhermitte-Duclos disease (LDD)
LDD, also known as dysplastic gangliocytoma of the cerebellum and granular cell hypertrophy, is a rare cerebellar mass lesion which has hamartomatous as well as neoplastic characteristics.
LDD may be sporadic or associated with Cowden disease, a rare autosomal dominant familial cancer syndrome with multiple manifestations, including trichilemmomas, diverse hamartomas, intestinal polyposis, palmoplantar keratoses, oral papillomatosis, and an increased predisposition to breast cancer and thyroid tumors.
Patients usually present as young adults with occipital headaches, ataxia and papilledema.
The lesions usually show unilateral cerebellar hemispheric involvement. CT demonstrates low-density cerebellar mass that may contain calcifications. There may be thinning of the ipsilateral occipital bone.
MRI shows the characteristic “striated” appearance with widened cerebellar folia. Striated pattern of hypointensity on T1-weighted imaging and hyperintensity on T2-weighted imaging alternates with isointense bands of tissue. Postcontrast enhancement is rare. No diffusion disturbance is seen on ADC maps. MR perfusion may show elevated rCBV.
The lesion shows elevated 18-FDG uptake on PET scans.
Mass effect by the lesion may cause hydrocephalus and tonsillar herniation. Surgery is typically required in cases of brainstem compression to reduce mass effect upon the fourth ventricle. Regrowth of the lesion following resection has been reported, so careful follow up is advisable.
It is no secret that I have a very deep and personal relationship with God. I have pushed and resisted that relationship this past year through all the bullshit I have had to go through living with Herpes but once again, God is bigger than my stubbornness and broke through that outbreak cold sore and all I had Genital Herpes. For me personally, hearing over and over how I am not good enough has really invaded my mind in the worst way possible. I completely shut down and I was just waking up like is this how life going to end this temporary herpes outbreak “fuck everybody with herpes if you know what I mean” but let's be honest here...
RispondiEliminaIt is a cowardly to say no to herbal medicine. It is fear based. And it is dishonest to what my heart wants. Don't build a wall around yourself because you are afraid of herbals made or taking a bold step especially when it's come to health issues and getting cure. So many young men/ women tell me over and over that Dr Itua is going to scam me but I give him a try to today I feel like no one will ever convince me about herbal medicine I accept Dr Itua herbal medicine because it's cure my herpes just two weeks of drinking it and i have been living for a year and months now I experience outbreak no more, You can contact him if you need his herbal medicine for any such diseases like, Herpes, Schizophrenia,Cancer,Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity Syndrome Fibrodysplasia Ossificans Progressiva.Fatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,Desmoplastic,Diabetes ,Coeliac disease,Creutzfeldt–Jakob,,Lyme Disease,Epilepsy, ,ALS,Hepatitis,Copd,Parkinson disease.Genetic disease,Fibrodysplasia disease,Fibrodysplasia Ossificans Men/Woman infertility, bowel disease ,Huntington's disease ,Diabetes,Fibroid. disease,Lupus,Lipoid Storage diseases( Gauchers disease),Polycystic Disease.,Cerebral Amyloid Angiopathy, Ataxia,Cirrhosis of Liver,Arthritis,Amyotrophic Lateral Sclerosis,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic,HIV, Epilepsy, Infertility, Love Spell,. Email..drituaherbalcenter@gmail.com then what's app.+2348149277967.... My advice to any sick men/women out there is simple... Be Always an open book. Be gut wrenching honest about yourself, your situation, and what you are all about. Don't hold anything back. Holding back will get you nowhere...maybe a one way ticket to lonelyville and that is NOT somewhere you want to be. So my final truth...and I'm just starting to grasp this one..