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Ring-enhancing cerebral lesion

MedGen UID:
1052429
•Concept ID:
CN378195
•
Finding
HPO: HP:0025738

Definition

An abnormal neuroimaging finding consisting in an area of decreased density surrounded by a bright rim from concentration of the enhancing contrast dye. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRing-enhancing cerebral lesion

Professional guidelines

PubMed

Management of Neurocysticercosis in Children: Association of Child Neurology Consensus Guidelines.
Sankhyan N, Kadwa RA, Kamate M, Kannan L, Kumar A, Passi GR, Sharawat IK, Singhi P; For Association of Child Neurology Delphi Group for Neurocysticerosis in Childhood
Indian Pediatr 2021 Sep 15;58(9):871-880. Epub 2021 Aug 2 PMID: 34338221
Opportunistic infections of the CNS in patients with AIDS: diagnosis and management.
Collazos J
CNS Drugs 2003;17(12):869-87. doi: 10.2165/00023210-200317120-00002. PMID: 12962527
Cerebral ring enhancing lesions and antituberculous treatment.
Heap B
BMJ 1991 Jun 29;302(6792):1604. doi: 10.1136/bmj.302.6792.1604-d. PMID: 1953881Free PMC Article

Recent clinical studies

Etiology

Glioblastoma: Changing concepts in the WHO CNS5 classification.
Chen J, Han P, Dahiya S
Indian J Pathol Microbiol 2022 May;65(Supplement):S24-S32. doi: 10.4103/ijpm.ijpm_1109_21. PMID: 35562131
A Brain Ring-Enhancing Lesion.
Lindsey M, Harrison N, Bridges J, Blossom J, Kishore S, Majithia V
Am J Med Sci 2018 Sep;356(3):304-308. Epub 2018 Feb 2 doi: 10.1016/j.amjms.2018.01.009. PMID: 30049410
Streptococcus anginosus (Streptococcus milleri Group) Pyomyositis in a 50-Year-Old Man with Acquired Immunodeficiency Syndrome: Case Report and Review of Literature.
Yassin M, Yadavalli GK, Alvarado N, Bonomo RA
Infection 2010 Feb;38(1):65-8. Epub 2009 Nov 10 doi: 10.1007/s15010-009-6002-9. PMID: 19904493
Intracranial haemorrhage resulting from unsuspected choriocarcinoma metastasis.
Suresh TN, Santosh V, Shastry Kolluri VR, Jayakumar PN, Yasha TC, Mahadevan A, Shankar SK
Neurol India 2001 Sep;49(3):231-6. PMID: 11593238
Cerebral toxoplasmosis in Danish AIDS patients.
Smith E, Pers C, Aschow C, Mathiesen L
Scand J Infect Dis 1991;23(6):703-9. doi: 10.3109/00365549109024297. PMID: 1815332

Diagnosis

Fungal Abscess in the Brain.
Goldberg JL, Giantini-Larsen A, Brennan CW
World Neurosurg 2022 Feb;158:216-217. Epub 2021 Dec 6 doi: 10.1016/j.wneu.2021.12.002. PMID: 34883274
HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease.
Vidal JE
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18:2325958219867315. doi: 10.1177/2325958219867315. PMID: 31429353Free PMC Article
Neurosarcoidosis.
Naqi R, Azeemuddin M
J Pak Med Assoc 2012 Mar;62(3):293-4. PMID: 22764471
Solitary cysticercus granuloma.
Garg RK, Malhotra HS
Expert Rev Anti Infect Ther 2012 May;10(5):597-612. doi: 10.1586/eri.12.35. PMID: 22702323
Multiple ring-enhancing lesions of the brain.
Garg RK, Sinha MK
J Postgrad Med 2010 Oct-Dec;56(4):307-16. doi: 10.4103/0022-3859.70939. PMID: 20935408

Therapy

HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease.
Vidal JE
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18:2325958219867315. doi: 10.1177/2325958219867315. PMID: 31429353Free PMC Article
A Brain Ring-Enhancing Lesion.
Lindsey M, Harrison N, Bridges J, Blossom J, Kishore S, Majithia V
Am J Med Sci 2018 Sep;356(3):304-308. Epub 2018 Feb 2 doi: 10.1016/j.amjms.2018.01.009. PMID: 30049410
Disseminated Nocardia paucivorans infection in an immunocompetent host.
Hammoud M, Kraft C, Pulst-Korenberg J, Chenoweth C, Gregg KS
Infection 2014 Oct;42(5):917-20. Epub 2014 Mar 15 doi: 10.1007/s15010-014-0609-1. PMID: 24634088
Balamuthia mandrillaris meningoencephalitis in an immunocompetent patient: an unusual clinical course and a favorable outcome.
Jung S, Schelper RL, Visvesvara GS, Chang HT
Arch Pathol Lab Med 2004 Apr;128(4):466-8. doi: 10.5858/2004-128-466-BMMIAI. PMID: 15043486
Focal seizures with single small ring-enhancing lesion.
Singhi P, Ray M
Semin Pediatr Neurol 1999 Sep;6(3):196-200; discussion 200-1. doi: 10.1016/s1071-9091(99)80013-8. PMID: 10522339

Prognosis

Retinopathy With Multiple Cerebral Ring-Enhancing Lesions in a Young Man.
Xie N, Yang J, Sun Q
JAMA Ophthalmol 2021 Feb 1;139(2):236-237. doi: 10.1001/jamaophthalmol.2020.4620. PMID: 33331852
An Acute Case of Granulomatous Amoebic Encephalitis-Balamuthia mandrillaris Infection.
Takei K, Toyoshima M, Nakamura M, Sato M, Shimizu H, Inoue C, Shimizu Y, Yagita K
Intern Med 2018 May 1;57(9):1313-1316. Epub 2018 Jan 11 doi: 10.2169/internalmedicine.0011-17. PMID: 29321406Free PMC Article
Ring-enhancing pontine lesion in a young boy.
Gabel BC, Levy ML, Yoon J, Crawford JR
BMJ Case Rep 2013 Sep 13;2013 doi: 10.1136/bcr-2013-201335. PMID: 24038297Free PMC Article
Solitary cysticercus granuloma.
Garg RK, Malhotra HS
Expert Rev Anti Infect Ther 2012 May;10(5):597-612. doi: 10.1586/eri.12.35. PMID: 22702323
Balamuthia mandrillaris meningoencephalitis in an immunocompetent patient: an unusual clinical course and a favorable outcome.
Jung S, Schelper RL, Visvesvara GS, Chang HT
Arch Pathol Lab Med 2004 Apr;128(4):466-8. doi: 10.5858/2004-128-466-BMMIAI. PMID: 15043486

Clinical prediction guides

Infectious brain abscesses and granulomas: analysis of 110 episodes in adults.
Hesari Z, Haddad M, Sheybani F, Khoroushi F, Keykhosravi E, Morovatdar N
BMC Neurol 2024 Nov 18;24(1):449. doi: 10.1186/s12883-024-03953-0. PMID: 39558263Free PMC Article
Classification of brain lesions using a machine learning approach with cross-sectional ADC value dynamics.
Solar P, Valekova H, Marcon P, Mikulka J, Barak M, Hendrych M, Stransky M, Siruckova K, Kostial M, Holikova K, Brychta J, Jancalek R
Sci Rep 2023 Jul 15;13(1):11459. doi: 10.1038/s41598-023-38542-7. PMID: 37454179Free PMC Article
The value of asphericity derived from T1-weighted MR in differentiating intraparenchymal ring-enhancing lesions-comparison of glioblastomas and brain abscesses.
Zeng T, Xu Z, Yan J
Neurol Sci 2021 Dec;42(12):5171-5175. Epub 2021 Apr 1 doi: 10.1007/s10072-021-05226-x. PMID: 33796946
Retinopathy With Multiple Cerebral Ring-Enhancing Lesions in a Young Man.
Xie N, Yang J, Sun Q
JAMA Ophthalmol 2021 Feb 1;139(2):236-237. doi: 10.1001/jamaophthalmol.2020.4620. PMID: 33331852
Opportunistic infections of the CNS in patients with AIDS: diagnosis and management.
Collazos J
CNS Drugs 2003;17(12):869-87. doi: 10.2165/00023210-200317120-00002. PMID: 12962527

Recent systematic reviews

The etiological spectrum of multiple ring-enhancing lesions of the brain: a systematic review of published cases and case series.
Garg RK, Paliwal V, Pandey S, Uniyal R, Agrawal KK
Neurol Sci 2024 Feb;45(2):515-523. Epub 2023 Sep 28 doi: 10.1007/s10072-023-07083-2. PMID: 37768475
Laser Interstitial Thermal Therapy Induces Robust Local Immune Response for Newly Diagnosed Glioblastoma With Long-term Survival and Disease Control.
Chandar JS, Bhatia S, Ingle S, Mendez Valdez MJ, Maric D, Seetharam D, Desgraves JF, Govindarajan V, Daggubati L, Merenzon M, Morell A, Luther E, Saad AG, Komotar RJ, Ivan ME, Shah AH
J Immunother 2023 Nov-Dec 01;46(9):351-354. Epub 2023 Sep 19 doi: 10.1097/CJI.0000000000000485. PMID: 37727953Free PMC Article
Systematic review of neuroparacoccidioidomycosis: The contribution of neuroimaging.
de Oliveira VF, Magri MMC, Levin AS, Silva GD
Mycoses 2023 Feb;66(2):168-175. Epub 2022 Sep 13 doi: 10.1111/myc.13525. PMID: 36062632

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