Abstract
This paper describes a case of Balo's concentric sclerosis, a rare demyelinating disease of the central nervous system (CNS), which is currently classified as multiple sclerosis. In recent years, there has been a more favorable clinical course of Balo's sclerosis. The significant polymorphism of clinical manifestations of the disease, its neuroimaging pattern, and laboratory tests cause difficulties diagnosing this pathology. Its differentiation with CNS tumors presents a particular challenge. So it also happens in the described clinical case, when computed tomography revealed the signs of space-occupying lesion, the histological pattern of concentric focus biopsy specimen indicated the presence of protoplasmic astrocytoma. However, immunohistochemical analyses of the biopsy specimen, immunological examination of cerebrospinal fluid, as well as the typical magnetic resonance imaging changes of Balo's sclerosis could suggest the demyelinating nature of the pathological process. The article shows that immunohistochemical techniques for examining a brain biopsy specimen and immunological assays of blood and cerebrospinal fluid are of great diagnostic value.
Highlights
This paper describes a case of Balo's concentric sclerosis, a rare demyelinating disease of the central nervous system (CNS), which is currently classified as multiple sclerosis
Наблюдалась зона структурных нарушений в веществе головного мозга на границе левых лобной и теменной долей (с наличием постбиопсийных изменений в центральных отделах), локального очага глиоза в левой лобной доле
Данный клинический пример показывает, что, несмотря на значительный прогресс методов нейровизуализации, иммунологической диагностики и функциональных методов исследования, дифференциальная диагностика с опухолями некоторых редких демиелинизирующих заболеваний, все еще представляет значительную сложность для специалистов [7]
Summary
This paper describes a case of Balo's concentric sclerosis, a rare demyelinating disease of the central nervous system (CNS), which is currently classified as multiple sclerosis. Впервые демиелинизирующее заболевание ЦНС, характеризующееся возникновением зон разрушения белого вещества участков головного мозга концентрической формы, было описано в 1928 г. При повторном осмотре был выявлен субфебрилитет до 37,5 °С. Позже были описаны еще около 100 случаев подобных морфологических проявлений, выявленных как при аутопсии, так и при проведении магнитно-резонансной томографии (МРТ) головного мозга.
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