Unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage
Introduction. Neuromyelitis optica spectrum disorder (NMOSD) represents an immune-mediated neuroinflammatory syndrome, classified as a separate entity after the discovery of aquaporin-4 immunoglobulin G (anti-AQP4-IgG). The magnetic resonance neuroimaging spectrum of NMOSD classically consists of bi...
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| Format: | Article |
| Language: | English |
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Military Health Department, Ministry of Defance, Serbia
2022-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100086N.pdf |
| _version_ | 1811155194494320640 |
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| author | Nosek Igor Boban Jasmina Vlahović Dmitar Radovanović Biljana Kostić Dejan Kozić Duško |
| author_facet | Nosek Igor Boban Jasmina Vlahović Dmitar Radovanović Biljana Kostić Dejan Kozić Duško |
| author_sort | Nosek Igor |
| collection | DOAJ |
| description | Introduction. Neuromyelitis optica spectrum disorder (NMOSD) represents an immune-mediated neuroinflammatory syndrome, classified as a separate entity after the discovery of aquaporin-4 immunoglobulin G (anti-AQP4-IgG). The magnetic resonance neuroimaging spectrum of NMOSD classically consists of bilateral optic neuritis and longitudinally extensive transverse myelitis (LETM), recently broadened with lesions in area postrema, diencephalon, brainstem and cerebellum, and extensive cord atrophy. Case report. The case presents an anti-AQP4 autoantibody-positive 65-year-old female patient who initially presented with underestimated LETM and developed multiple cerebral and cerebellar lytic demyelinating lesions associated with acute long segment op-tic nerve involvement two years later. Two new imaging findings were described in this case: the involvement of a complete cross-sectional area of pons and microhemorrhage in the pons and corpus callosum. Conclusion. Raising suspicion of NMOSD is of crucial importance in cases with isolated LETM in order to prevent relapses in anti-AQP4-IgG positive cases and improve patient outcomes and recovery. |
| first_indexed | 2024-04-10T04:30:10Z |
| format | Article |
| id | doaj.art-fa0e3cc06c164ba28c1b6512d10bd0d1 |
| institution | Directory Open Access Journal |
| issn | 0042-8450 2406-0720 |
| language | English |
| last_indexed | 2024-04-10T04:30:10Z |
| publishDate | 2022-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-fa0e3cc06c164ba28c1b6512d10bd0d12023-03-10T08:07:50ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202022-01-0179121270127310.2298/VSP201126086N0042-84502100086NUnrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhageNosek Igor0https://orcid.org/0000-0002-7440-9090Boban Jasmina1https://orcid.org/0000-0001-9701-5484Vlahović Dmitar2https://orcid.org/0000-0003-0198-0111Radovanović Biljana3Kostić Dejan4https://orcid.org/0000-0002-4420-6348Kozić Duško5https://orcid.org/0000-0002-6007-7072Oncology Institute of Vojvodina, Center for Diagnostic Imaging, Sremska Kamenica, SerbiaOncology Institute of Vojvodina, Center for Diagnostic Imaging, Sremska Kamenica, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, SerbiaUniversity Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + University Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, SerbiaMilitary Medical Academy, Department of Computerized Tomography and Magnetic Resonance, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaOncology Institute of Vojvodina, Center for Diagnostic Imaging, Sremska Kamenica, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, SerbiaIntroduction. Neuromyelitis optica spectrum disorder (NMOSD) represents an immune-mediated neuroinflammatory syndrome, classified as a separate entity after the discovery of aquaporin-4 immunoglobulin G (anti-AQP4-IgG). The magnetic resonance neuroimaging spectrum of NMOSD classically consists of bilateral optic neuritis and longitudinally extensive transverse myelitis (LETM), recently broadened with lesions in area postrema, diencephalon, brainstem and cerebellum, and extensive cord atrophy. Case report. The case presents an anti-AQP4 autoantibody-positive 65-year-old female patient who initially presented with underestimated LETM and developed multiple cerebral and cerebellar lytic demyelinating lesions associated with acute long segment op-tic nerve involvement two years later. Two new imaging findings were described in this case: the involvement of a complete cross-sectional area of pons and microhemorrhage in the pons and corpus callosum. Conclusion. Raising suspicion of NMOSD is of crucial importance in cases with isolated LETM in order to prevent relapses in anti-AQP4-IgG positive cases and improve patient outcomes and recovery.http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100086N.pdfanti-aquaporin 4 autoantibodymagnetic resonance imagingneuroinflammatory diseasesneuromyelitis opticatreatment outcome |
| spellingShingle | Nosek Igor Boban Jasmina Vlahović Dmitar Radovanović Biljana Kostić Dejan Kozić Duško Unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage Vojnosanitetski Pregled anti-aquaporin 4 autoantibody magnetic resonance imaging neuroinflammatory diseases neuromyelitis optica treatment outcome |
| title | Unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage |
| title_full | Unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage |
| title_fullStr | Unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage |
| title_full_unstemmed | Unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage |
| title_short | Unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage |
| title_sort | unrecognized neuromyelitis optica spectrum disorder with pontine and corpus callosum microhemorrhage |
| topic | anti-aquaporin 4 autoantibody magnetic resonance imaging neuroinflammatory diseases neuromyelitis optica treatment outcome |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100086N.pdf |
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