A woman in her mid-20s presents with headaches, nausea and amenorrhea

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Presentation transcript:

A woman in her mid-20s presents with headaches, nausea and amenorrhea Teaching NeuroImages Neurology Resident and Fellow Section © 2017 American Academy of Neurology

Presentation Six-month history of worsening headaches, amenorrhea and nausea Neurological examination demonstrated word-finding difficulties, mild right-sided weakness of the upper and lower extremities, and mild right-sided neglect Smith-Cohn et al. © 2017 American Academy of Neurology

Imaging Smith-Cohn et al. Figure. Computed tomography and magnetic resonance imaging scans of the brain showing a central gangliocytoma. Axial (A, B), sagittal (C), and coronal (D) views showing a 5×5×4-cm cystic mass resulting in hydrocephalus. Incidentally, an approximate 2-cm displacement of the cerebellar tonsils is evident (C), consistent with a Chiari I malformation. The presentation of amenorrhea can be attributed radiographically to the increased intracranial pressure reflected by the enlarged suprasellar cistern and by the direct contact of the mass with the hypothalamus. Smith-Cohn et al. © 2017 American Academy of Neurology

“Central Neurocytoma” Benign tumor that typically affects young adults Arises from subependymal neural progenitor cells Comprises 0.25-0.5% of all brain tumors Treatment consists of surgery and radiation therapy Generally carries a favorable prognosis References (1) Schmidt MH, Gottfried ON, von Koch CS, Chang SM, McDermott MW. Central neurocytoma: a review. J Neurooncol. 2004;66:377–384 (2) Sim FJ, Keyoung HM, Goldman JE, et al. Neurocytoma Is a Tumor of Adult Neuronal Progenitor Cells. J Neurosci. 2006;26:12544–12555 Smith-Cohn et al. © 2017 American Academy of Neurology