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November 1965

Demyelinating Disease Presenting as an Intracranial Mass Lesion

Author Affiliations

From the departments of neurology and radiology, College of Physicians and Surgeons, Columbia University and the New York Neurological Institute, Columbia-Presbyterian Medical Center. Chief Resident in Neurology, Presbyterian Hospital and Assistant in Neurology, College of Physicians and Surgeons, Columbia University (Dr. Prockop), and Special Fellow in Neuroradiology, National Institute of Neurological Diseases and Blindness, National Institutes of Health, BT-973-2. Currently Assistant Professor of Radiology, Emory University Clinic, Atlanta (Dr. Heinz).

Arch Neurol. 1965;13(5):559-564. doi:10.1001/archneur.1965.00470050107014

I. Introduction  IT IS WELL KNOWN that many non-neoplastic disease entities may give symptoms and signs which mimic those of an expanding intracranial lesion. None of our diagnostic procedures, including cerebral angiography, is always definitive in diagnosis of the entities. They include: congenital lesions such as aneurysm,1 and arteriovenous malformation2; focal inflammatory and infectious diseases such as brain abscess3; intracranial hemorrhage, infarct formation or edema formation secondary to cerebrovascular disease4; and trauma.4 Leukoencephalopathy of the hemorrhagic type, one form of demyelinating disease, has been reported to present as an intracranial mass lesion, in which the mass effect is related to hemorrhage.5 It is the purpose of this paper to report a case with demyelinating disease without hemorrhage in which the clinical symptoms and cerebral angiograms were interpreted as indicating an expanding intracranial lesion and led to the presumptive diagnosis of brain tumor.