Schilder’s disease: non-invasive diagnosis? |
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Authors: | Susanna Bacigaluppi Gabriele Polonara Mario L Zavanone Rolando Campanella Vincenzo Branca Sergio M Gaini Giovanni Tredici Antonella Costa |
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Institution: | 1.Department of Neurosurgery,Università degli Studi di Milano, Ospedale Policlinico Mangiagalli e Regina Elena, Fondazione I.R.C.C.S.,Milan,Italy;2.Department of Neuroradiology,Università degli Studi di Milano, Ospedale Policlinico Mangiagalli e Regina Elena, Fondazione I.R.C.C.S.,Milan,Italy;3.Department of Neuroradiology,Università Politecnica delle Marche,Ancona,Italy;4.Department of Neurosciences and Biomedical Technologies,Università degli Studi di Milano Bicocca,Monza,Italy |
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Abstract: | Schilder’s disease, or myelinoclastic diffuse sclerosis, is a rare disorder characterised by an inflammatory white matter
plaque of demyelination. Clinical signs and symptoms might be atypical for early multiple sclerosis and at imaging the lesion
is easily taken for a brain tumour. Regardless of the use of Poser’s criteria for clinical diagnosis of Schilder’s disease
proposed in 1986, diagnostic difficulties are still present, as evidenced by the many reported cases in the English literature
revised (Pubmed indexed, period 1998–2008). It clearly emerges that neuroradiological features, observable in additional magnetic
resonance sequences are crucial, besides the consideration of Poser’s criteria, in differentiating between demyelinating lesions
and brain tumours. A 29-year-old female patient is presented, where a careful evaluation of both the clinical and radiological
features, which might have been at a first glance misleadingly suggestive for a brain tumour, allowed non-invasive diagnosis
of Schilder’s disease. |
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