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Hydatid cyst, which is caused by the cestode echinococcus granulosus, is endemic in many countries around the world. Despite the frequency of this disease, no previous case of cerebral hydatid cyst with orbital extension has been reported, demonstrating the scarcity of this presentation. Cerebral hydatid cyst may be primary or secondary. Given to the nonspecifity of the clinical symptoms, cross sectional imaging, including CT and MRI, play an important role in the diagnosis by ruling out differential diagnoses, which are represented essentially by neoplastic and nonneoplastic intraparenchymal cysts as well as brain abscesses. Surgery remains the cornerstone treatment for cerebral and orbital hydatid cyst. In this article, we present the imaging findings of a patient with a primary cerebral hydatid cyst with orbital extension, and also the radiological features that could eliminate other differential diagnoses.

Abstract Background Spinal arachnoid web (AW) is a very rare entity, with a limited number of cases documented in the literature. Our manuscript represented a comprehensive general review, encompassing various aspects of the subject matter without focusing on any single element. The objective of this systematic review was to describe and analyze reported cases of surgically proven spinal arachnoid webs (AWs) to elucidate their imaging and clinical features, pathophysiology, and optimal management strategies, and to determine the total number of documented cases in the literature. Patterns and commonalities across reported cases were identified to provide a clearer framework for diagnosing and treating this elusive condition. A search of Web of Science, PubMed, and Scopus, respecting PRISMA guidelines, was conducted to include reported cases of surgically proven spinal AW. Our surgically proven case was included as well. Main body of the abstract The search yielded 196 cases of surgically confirmed spinal AWs in the literature. Adding our case, the total is 197. They are seen commonly in middle-aged patients, slightly more prevalent in males, and often without an evident cause. Sensation disturbances were the most frequently found clinical signs, followed by gait difficulties, weakness, and pain. Symptoms were predominantly located in the lower limbs and trunk. On imaging, an indentation to the rear aspect of the spinal cord was most frequently found at the mid-thorax followed by the upper thorax, often associated with a syrinx or a hyperintense T2 cord signal, usually extending rostrally. Excision was the most efficient treatment. Short conclusion The assessment found that AW cases are rare in the literature, indicating the disease's scarcity. It manifests insidiously, with the shortest latency reported being 2 weeks. Upper limb symptoms occur in a quarter of cases regardless of the AW's thoracic location, likely due to rostral syrinx and cerebrospinal fluid flow disturbances. Most pathology results revealed fibrous connective tissue, similar to findings in arachnoid cysts, suggesting that AW may result from a ruptured arachnoid cyst or its precursor. Using 3D SPACE STIR and CISS MRI sequences is recommended to visualize the arachnoid band directly.

Intracranial dermoid cysts are rare slow-growing cystic lesions. They are frequently extra-axial, intra-axial localization is very rare. These benign congenital ectodermal inclusions cysts have a rare risk of rupture. Ruptured dermoid cysts can manifest with headache, epilepsy seizure, cerebral infarction, meningitis, and hydrocephaly. Neuroimaging features are quite characteristic. We report a case of a 30-year-old male who presented to the emergency room with subacute-onset headaches. CT scan and MRI show a ruptured intracranial dermoid cyst.

Eagle syndrome is defined as a collection of symptoms affecting the cervical and cranial regions, resulting from an elongated styloid process or ossified stylohyoid ligament encroaching on surrounding structures and causing a variety of symptoms. Classically, Eagle syndrome presents as neck, throat, or ear pain. Carotid artery dissection is a rare complication of Eagle syndrome. We report the case of a 40-year-old man who presented with bilateral internal carotid artery dissection secondary to pathological elongation of the styloid processes.

FLAMES, or fluid-attenuated inversion recovery-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein (anti-myelin oligodendrocyte glycoprotein)-associated encephalitis with seizures, represents a rarely documented syndrome characterized by ambiguous features. Positioned within the spectrum of inflammatory demyelinating diseases of the central nervous system, it is regarded as a distinct subset of myelin oligodendrocyte glycoprotein antibody-associated disease, the latest classification in this domain. Myelin oligodendrocyte glycoprotein antibody-associated disease exhibits a diverse clinical spectrum, spanning from solitary optic neuritis or myelitis to multifocal central nervous system demyelination, manifesting as acute disseminated encephalomyelitis, or cortical encephalitis accompanied by seizures, delineating the fluid-attenuated inversion recovery-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein-associated encephalitis with seizures syndrome. We present a compelling case study of a 30-year-old individual with a history of recurrent seizures initially diagnosed with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes. However, the disease’s progression more closely resembled self-resolving cerebral cortical encephalitis linked with myelin oligodendrocyte glycoprotein antibodies. In addition, we undertake a systematic review of literature cases to explore the diagnostic significance of magnetic resonance angiography, fluid-attenuated inversion recovery, and specialized markers such as diffusion-weighted imaging and perfusion in discerning fluid-attenuated inversion recovery-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein-associated encephalitis with seizures syndrome and elucidating its distinctive characteristics.

Teaching point: Magnetic resonance imaging (MRI) has significantly improved the evaluation of brachial plexus injuries, offering new possibilities for microsurgical repair and contributing to the functional prognosis.

Infantile fibromatosis is a rare mesenchymal disorder characterized by the fibrous proliferation of the skin, bone, muscle, and viscera. The clinical features vary from solitary to multicentric forms with similar pathological features. Although the tumor is histologically benign, it is a highly infiltrating lesion making the prognosis poor for patients with craniofacial involvement affection due to the major risk of nerve vascular and airway compression syndrome. The solitary form of infantile fibromatosis observed in the dermis, subcutis, or fibromatosis tends to occur predominantly in males and typically affects craniofacial deep soft tissues. We present a case of an unusual symptom presentation and a rarely observed location of a solitary fibromatosis form, affecting the muscle of the forearm and infiltrating the bone in a 12-year-old girl. Imaging findings were suggestive of rhabdomyosarcoma, but histopathology set the diagnosis of an infantile fibromatosis. The patient, then, received chemotherapy, and amputation was proposed due to the inextricability of this benign yet aggressive tumor, an option that was refused by her parents. We discuss through this article the clinical, radiological, and pathological features of this benign yet aggressive condition, the potential differential diagnosis, the prognosis, and treatment options substantiated with concrete examples from the literature.

Teaching Point: Subarachnoid hemorrhage is a rare complication of spinal dural arteriovenous fistulas (dAVF) with very characteristic imaging features, knowledge of which is crucial for positive diagnosis and rapid management.

Pulmonary air leak syndromes involve dissection of air out of the normal pulmonary airspaces and include pulmonary interstitial emphysema, pneumothorax, pneumomediastinum, pneumopericardium, pneumoperitoneum, subcutaneous emphysema and systemic air embolism. It presents as a spontaneous extension of dissecting air without a history of a procedure or penetrating injury. Pulmonary air leak syndromes are extremely rare complications of systemic autoimmune connective tissue diseases. Few cases were reported in the literature regarding rheumatoid arthritis patients. The purpose of this article is to emphasize on this rare pulmonary complication and discuss the physiopathology of the disease and the different risk factors for a better management of these patients. We report the case of a 45-year-old female, with a history of proven rheumatoid arthritis under methotrexate and steroids, who presented with a spontaneous dissecting subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumoperitoneum. The patient’s condition improved after chest drainage and adjustment of her medical treatment.

The occipital bone is an uncommon location for meningoceles protrusion. This condition occurs generally after a severe traumatism or surgical procedure. However, in some rare cases, the herniation can happen spontaneously. Nontraumatic clival meningoceles present an extremely rare entity and correspond to a herniating pachymeningeal collection containing cerebrospinal fluid through a zone of fragility in the clivus. Clinical presentation ranges from simple headache or rhinorrhea to severe complications such as recurrent bacterial meningitis or nerve compression. Computed tomography provides an analysis of the bone and magnetic resonance imaging provides a superior contrast resolution, helping to distinguish among the various types of clival lesions. We report the case of a young woman with a long history of idiopathic intracranial hypertension, who presented with a worsening headache. Magnetic resonance imaging confirmed a clival meningocele without other complications and the patient was put under medical surveillance.

Arachnoid cysts are the most common benign cystic abnormalities formed due to congenital splitting of the arachnoid layer. They comprise 1% of intracranial masses, and the orbital location is even more rarely reported in history especially in the pediatric population. They might be discovered as an asymptomatic finding on imaging performed for a concomitant condition or, in most reported cases, as a result of ophthalmic impairment. They can be isolated or associated with gliomas, neurofibromas, empty sella syndrome, and frontotemporal porencephalic cysts. Computed tomography scan shows a non-enhancing liquid cystic lesion, and magnetic resonance imaging remains the best assessment tool confirming the similarity of the fluid to cerebrospinal fluid and evaluating the optic nerves. Herein, we report the case of an incidental discovery of an intraorbital arachnoid cyst on magnetic resonance imaging in a 53-year-old woman with a history of epilepsy. No treatment was performed as the cystic formation was asymptomatic.