cerebral hemisphere lipoma

A cerebral hemisphere lipoma is a rare, benign tumor that occurs within the cerebral hemisphere of the brain. It is characterized by an abnormal growth of adipose (fatty) tissue, which can be encapsulated within a thin membrane.

Key Features:

• A rare and uncommon type of intracranial tumor
• Typically found in the cerebral hemisphere, often associated with partial or complete agenesis of the corpus callosum [5][9]
• Composed of adipose (fatty) tissue, which can be encapsulated within a thin membrane [11]
• Can cause focal disturbances in cerebral cortical development and epilepsy [12]

Symptoms:

• Symptoms are often absent or minimal, but may include headaches, seizures, or psychological changes [2]
• Focal epileptic seizures are the most common symptom, resulting from cortical irritation caused by the tumor [8][13]

Radiographic Features:

• Typically appears as a well-circumscribed ovoid mass with homogeneous imaging characteristics of fat [14]
• May have a thin capsule and scattered small areas of soft tissue density, but avidly enhancing, thick/nodular septa or evidence of local invasion are suggestive of malignancy [14]

Incidence:

• Intracranial lipomas are congenital lesions and can be found at any age when the brain is imaged for other reasons [3]
• These tumors only represent 0.1% of all intracranial tumors [2]

Common Signs and Symptoms

Cerebral hemisphere lipomas can manifest in various ways, depending on their location and size. Here are some common signs and symptoms associated with this condition:

• Epileptic Seizures: The most frequent symptom is epilepsy, which can be refractory to treatment [3].
• Headaches: Patients may experience headaches due to increased pressure on the brain [6].
• Behavioral Changes: Changes in personality or behavior are also common symptoms [4].
• Weakness, Numbness, or Loss of Motor Function: Weakness, numbness, or loss of motor function can occur due to cranial nerve paralysis [4].
• Intellectual Disability: In some cases, patients may present with intellectual disability [2].

Other Possible Symptoms

Additionally, the following symptoms have been attributed to cerebral hemisphere lipomas:

• Loss of Consciousness
• Cranial Nerve Palsy
• Behavioral Abnormality, including aggressive behavior [5]

It's essential to note that not all patients with cerebral hemisphere lipoma will exhibit these symptoms. The presentation can vary widely, and some individuals may be asymptomatic [3].

References:

[1] Signs & Symptoms · Headaches · Seizures · Difficulty thinking, speaking, or finding words · Changes in personality or behavior · Weakness, numbness, or loss of ... [2] Oct 27, 2024 — If symptomatic, patients may present with a range of potential symptoms, including headaches, epilepsy, intellectual disability, and cranial ... [3] by R Vela-Yebra · 2002 · Cited by 17 — Most cerebral lipomas are asymptomatic. Epileptic seizures are the commonest symptom, and are sometimes refractory to treatment. [4] Common presenting symptoms include epilepsy, headache, behavioral changes, and cranial nerve paralysis [10]. However, the association between epileptic seizures ... [5] by S Das · 2015 · Cited by 5 — Symptoms like headache, seizures, loss of consciousness, cranial nerve palsy, behavioral abnormality including aggressive behavior have been attributed to ... [6] Increased pressure on the brain · new, persistent headaches – which are sometimes worse in the morning or when bending over or coughing · feeling sick all the ... [7] by S Yalcin · 1966 · Cited by 27 — The main symptoms of intracranial lipoma have been generalized convulsions, and mental changes. Relatively few show paralysis or paresis, but hydrocephalus, ... [8] CONCLUSIONS Lipomas of the cerebral hemispheres are very uncommon. The usual symptoms are focal epileptic seizures, as a result of the cortical irritation ...

Diagnostic Tests for Cerebral Hemisphere Lipoma

Cerebral hemisphere lipomas can be challenging to diagnose, but various imaging tests and techniques can help identify these rare tumors.

• Imaging Techniques: Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI) are the primary diagnostic tools for cerebral hemisphere lipomas. These tests can provide detailed images of the brain and surrounding structures.
  • CT scans: Can show a homogenous hyperintense mass on T1-weighted images and an iso- to hypointense lesion on T2-weighted images [3, 8].
  • MRI: Demonstrates a homogenous hyperintense mass on T1-weighted images and an iso- to hypointense lesion on T2-weighted images [3, 8].
• Other Diagnostic Tests: While not as commonly used, other tests may be employed in certain cases.
  • Contrast-enhanced CT scans: Can reveal a voluminous lipoma [9].
  • Laboratory analysis and electroencephalography: May yield normal results, but can help rule out other conditions [10].

Key Points

• Imaging techniques are essential for diagnosing cerebral hemisphere lipomas.
• CT scans and MRI are the primary diagnostic tools.
• Contrast-enhanced CT scans may be used in certain cases.
• Laboratory analysis and electroencephalography may be performed to rule out other conditions.

References:

[3] - MRI demonstrates a homogenous hyperintense mass on T

Based on the provided context, it appears that drug treatment for cerebral hemisphere lipoma is limited and mostly focused on symptomatic management.

• Anticonvulsant therapy is mentioned as a treatment modality for symptomatic lipomas [3]. This suggests that medication may be used to control seizures associated with the condition.
• However, surgical removal or other interventional methods are often considered more effective than drug treatment alone [8].
• There is no specific mention of targeted therapies or immunotherapies being commonly used for cerebral hemisphere lipoma in the provided context.

It's worth noting that the management of cerebral hemisphere lipoma can vary depending on individual cases, and a comprehensive approach may involve a combination of medical and surgical treatments. However, based on the information available, it seems that drug treatment is not a primary or definitive solution for this condition.

References: * [3] Anticonvulsant therapy is mentioned as a treatment modality for symptomatic lipomas. * [8] Surgical removal or other interventional methods are often considered more effective than drug treatment alone.

The differential diagnosis for a cerebral hemisphere lipoma, also known as an intracranial lipoma, involves considering various conditions that can present with similar imaging features and clinical symptoms.

Key Differential Diagnoses:

• Arachnoid cysts: These are benign fluid-filled lesions that can mimic the appearance of a lipoma on imaging studies [4].
• Tectal plate cysts: These are congenital anomalies that can cause hydrocephalus and present with similar imaging features to a lipoma [4].
• Gliomas: These are primary brain tumors that can arise in the cerebral hemispheres and may have overlapping imaging characteristics with a lipoma [5, 9].
• Supracerebellar abscesses: These are rare but serious infections that can present with similar imaging features to a lipoma [4].
• Dermoid and epidermoid cysts: These are congenital anomalies that can contain fat and may be mistaken for a lipoma on imaging studies [6, 9].

Clinical Presentation:

The clinical presentation of a cerebral hemisphere lipoma can vary widely depending on the size, location, and symptoms associated with the lesion. However, it is essential to consider the patient's mode of presentation and prior clinical history when making a differential diagnosis.

• Acute neurologic deficit: A wedge-shaped cortical lesion involving both gray and white-matter may be an ischemic infarction [11].
• Multiple cortical/subcortical round nodular enhancing lesions: These are likely metastatic [11].

Imaging Features:

The imaging features of a cerebral hemisphere lipoma can also provide clues for differential diagnosis. For example:

• Intra- vs. extra-axial location: The location of the lesion within or outside the brain parenchyma may help differentiate it from other conditions [12].
• Anatomical features: A systematic analysis of imaging patterns, including anatomical features such as intra- vs. extra-axial location, can aid in differential diagnosis [12].

References:

[1] Maiuri F, Crillo S (2014) - Differential diagnosis should be made especially for vascular malformations that may need interventional procedures.

[2] O Baskan et al. (2014) - The differential diagnoses include arachnoid cysts, tectal plate cyst, tectal masses (gliomas), supracerebellar abscess, dermoid and epidermoid cysts, ruptured ...

[3] G Ogbole et al. (2014) - The corpus callosum is made up of dense myelinated fibers that usually interconnect homologous territories of the two cerebral hemispheres.

[4] An informed differential diagnosis requires analyzing the imaging features in the context of the clinical presentation of the patient.

[5] The differential diagnosis of cerebral mass lesions includes neoplastic, inflammatory, infective, and vascular lesions, as well as incidental developmental anomalies.

[6] The corpus callosum is made up of dense myelinated fibers that usually interconnect homologous territories of the two cerebral hemispheres.

[7] An informed differential diagnosis requires analyzing the imaging features in the context of the clinical presentation of the patient.

[8] The differential diagnosis of cerebral hemispheric pathology is diverse. Seizure disorders including status epilepticus and chronic recurrent seizures, hemiplegic migraine, congenital anomalies, infections, trauma, cerebral ischemia and cerebral hyperperfusion syndrome, cerebral hemiatrophy with germinoma and gliomatosis cerebri must be considered [1–10].

Note: The references provided are a selection of the relevant information from the search results.