ABSTRACT
Pilocytic astrocytoma (PA) is a benign tumor that rarely spread along the neuraxis. At the moment there are no more than five cases of leptomeningeal dissemination (LD) from PA at diagnosis described in the literature. Different patterns of presentation or recurrence may be noted: local recurrence, malignant transformation, multicentric disease or metastatic disease. LD and multicentric disease can be distinct pathological entities. We report two cases and analyse literature, emphasizing leptomeningeal spread at presentation. Hydrocephalus, biopsy and parcial ressection are likely to be favorable factors to the occurrence of LD. Otherwise, LD may be part of natural history of PA, as evidenced by its ocurrence in non-treated cases
Subject(s)
Humans , Female , Child , Astrocytoma , Cerebellar Neoplasms , Meningeal Neoplasms , Astrocytoma , Cerebellar Neoplasms , Fatal Outcome , Hydrocephalus , Magnetic Resonance Imaging , Meningeal Neoplasms , Neoplasm Recurrence, Local , Subarachnoid Space , Tomography, X-Ray ComputedABSTRACT
As medidas basicas para o tratamento da claudicacao intermitente sao aquelas que visam reduzir a resistencia da rede circulatoria colateral e o controle dos fatores de risco. O objetivo desse trabalho e avaliar o resultado do tratamento clinico em pacientes com obstrucao de aorta abdominal estudando prospectivamente 55 pacientes por 26 meses. Verificamos grande melhora clinica no grupo de pacientes que aderiram ao tratamento clinico (melhora de 68,75 por cento dos casos X 39,1) e analisando-se o grupo de pacientes que nao realizaram o tratamento adequadamente, observou-se que os que fumavam mas seguiam treinamento, tiveram resultado significativamente superior aos que nao treinavam (73 por cento X 8,3 por cento)(p<0,01)...