Freiburg Neuropathology Case Conference

A Progressive Lesion of the Optic Tract, Brainstem, Hypothalamus and Basal Ganglia
  • C. A. TaschnerEmail author
  • S. Doostkam
  • P. C. Reinacher
  • H. Urbach
  • A. Rau
  • M. Prinz
Clinical Case

Case Report

A 63-year-old male patient presented with a 6-month history of reduction in performance and fatigue as well as a change in character and for 3 months he had an additional deterioration in vigilance with an increasing imperative urge to sleep and a frontal disinhibition, which led to admission to psychiatry. Magnetic resonance imaging (MRI) revealed a suspicious lesion of the right optic tract and the hypothalamus (Figs. 1 and 2). A stereotactic biopsy in the area of the right hypothalamus above the optic tract was performed, revealing only small cell groups of B and T cells , which were considered non-specific; however, the patient had been under corticotherapy in the month prior to the biopsy and 2 months later the patient presented in a clinically stable condition and the corticotherapy had been discontinued. On MRI new lesions had occurred (Figs. 3 and 4) located bilaterally in the basal ganglia and a second stereotactic biopsy was performed targeting out...


Compliance with ethical guidelines

Conflict of interest

C.A. Taschner, S. Doostkam, P.C. Reinacher, H. Urbach, A. Rau and M. Prinz declare that they have no competing interests.

Ethical standards

All investigations described in this manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current revised form). Informed consent was obtained from the patient in this case if identifiable from images or other information within the manuscript.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • C. A. Taschner
    • 1
    Email author
  • S. Doostkam
    • 2
  • P. C. Reinacher
    • 3
  • H. Urbach
    • 1
  • A. Rau
    • 1
  • M. Prinz
    • 2
  1. 1.Department of Neuroradiology, Medical CentreUniversity of FreiburgFreiburgGermany
  2. 2.Department of Neuropathology, Medical CentreUniversity of FreiburgFreiburgGermany
  3. 3.Department of Stereotactic and Functional Neurosurgery, Medical CentreUniversity of FreiburgFreiburgGermany

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