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外文期刊>Journal of Vascular and Interventional Neurology
>Auditory Hallucinosis as a Presenting Feature of Interpeduncular Lipoma with Proximal P1 Segment Fenestration: Report of a Rare Case and Review of Literature on Peduncular Hallucinosis
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Auditory Hallucinosis as a Presenting Feature of Interpeduncular Lipoma with Proximal P1 Segment Fenestration: Report of a Rare Case and Review of Literature on Peduncular Hallucinosis
The authors present a unique case of intracranial lipoma in the interpeduncular cistern associated with proximalP1 segment fenestration. This patient is a 20-year-old male with extensive psychiatric history andcomplaints of recent auditory hallucinations. Cranial magnetic resonance imaging (MRI) (T1, T2, andFLAIR) showed a hyperintense lesion in the left aspect of interpeduncular cistern with a prominent flowvoid within the hyperintense lesion suggestive of a combined vascular–lipomatous lesion. Computedtomography (CT) angiography showed a high-riding large tortuous P1 segment on the left side with proximalfenestration, the ectatic posteromedial limb harboring a fusiform dilated segment. Since there are anecdotalcases of cerebral aneurysms associated with intracranial lipomas, a conventional angiography wasdone, which confirmed a proximal left P1 fenestration and a fusiform-dilated segment, and no aneurysm.There are few cases of hallucinations associated with a vascular midbrain pathology reported in literature,but hallucinations associated with a combination of lipoma and arterial ectasia have never been reported.This article not only demonstrates the MRI and angiographic appearance of this rare lipomatous lesion butalso highlights this unique association and significance of auditory hallucinations as a clinical presentation,akin to peduncular hallucinosis.
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