Tuberculosis: a great masquerader

Central nervous system tuberculosis caused by Mycobacterium tuberculosis is the most severe form of tuberculosis, accounting for 1% of all TB cases. Intracranial tuberculosis can present as Tuberculous meningitis, Tuberculous encephalopathy, Tuberculous vasculitis, CNS tuberculomas and Tuberculous brain abscess. Here authors present a case of a 10-year-old girl who presented with insidious onset of early morning vomiting, excessive sleepiness with classical neuroimaging findings of intracranial tuberculosis. Authors emphasise that intracranial tuberculoma should be considered in the differential diagnosis of any intracranial space-occupying lesion with or without pulmonary involvement.

A Neuro-Behcet's Case Operated with the Intracranial Mass Misdiagnosis

Behcet's disease (BD) is an inflammatory systemic disorder with oral and genital ulcers, as well as ophthalmologic and cutaneous symptoms. Neurological manifestations in BD represent between 2.2% to 50% of the cases. The 25-year-old male patient, diagnosed with BD three years earlier, was admitted to our clinic with complaints of recurrent headaches. Tumor-like-parenchimal involvement was detected on a cranial magnetic resonance imaging. The lesion was removed surgically and then he suffered from right hemiparesis and epilepsy. Pathological examination of the lesion noted a demyelinating non-tumoural etiology. A neuro-Behget's case with parenchymal involvement has been examined in light of the literature, in terms of a tumor and a demyelinating disease differential diagnosis.

Evaluating effect of natrium hyposulphide for treatment of skin diseases due to chromium on experimental rabbits

The objective of study is to evaluate effects of natrium hyposulphide for treatment the occupational dermatosis due to chromium. 23 rabbits was ulcerated by kalium bichromate 6%, after that they were treated by Hysox 10% solution and Hynax 5% ointment (main composition was natri hyposulphide) and all rabbits were observed generally symptomatically, macro and micro-scopically, and microbiologically. Results showed that : after 2 weeks, the healing rate on the treated rabbit groups was 2.6 and 2.4 times higher than the control group. Authors recommended the further study and the production of this preparation in order to protect the workers exposed to chromium.

A Clinical Analysis of CT-guided Stereotactic Biopsy for Intracranial Mass Lesions

Using computed tomographic scanners, stereotactic guided brain biopsy usually permits safe and accurate pathologic diagnosis. In our department between 1991 and 1995, 35 patients underwent CT guided stereotactic biopsy and/or craniotomy with CRW stereotactic frame, and following results were obtained. 1) All lesions were supratentorial. As surgical intervention for the diagnosis, biopsy was carried out in 25(71.4%), aspiration of cystic content was in 2(6%), and stereotactic guided craniotomy was in 8 cases(23%) respectively. 2) A positive diagnosis could be obtained in 34 cases(97.1%), and inconclusive diagnosis disclosed in only one case (2.9%). Positive diagnoses included: 10 cases of astrocytoma(28.6%), 4 cases of glioblastoma(11.4%), metastasis, germinoma, and meningioma in that order. 3) It seemed to be difficcult to ascertain a grade and to search for any presence of mixed area in glioma cases, because open craniotomy was not carried out in all cases. 4) The biosy specimens were generally obtained with cup forceps, however a spiral needle core device with outer probe was very useful for obtaining tissue of tumor for an unavailable case with cup forceps. 5) The immediate post-operative CT scan after 3-4 hours of procedure gave information for accurate site of target under location of air bubble, and any evidence of complication such as hemorrhage. This study provides evidence that CT-guided stereotactic biopsy is a reliable, simple, and safe method for obtaining histological diagnosis of intracranial mass lesions.

CT-Guided Stereotaxis of Intracranial Mass Lesions: Its Complications and Diagnostic Accuracy of Biopsy

Surgical resection may not be the appropriate first treatment for all intracranial mass lesions, especially for deep or midline lesions. And a precise histopathological diagnosis is mandatory to develop adequate and specific treatments. The advent of modern imaging and CT-compatible stereotactic frames has greatly simplified the performance of streotactic procedure for small and deep seated brain tumors. We present a 44-month experience on 94 stereotactic procedures of intracranial mass lesions, using Brown-Roberts-Wells(BRW) and Cosman-Roberts-Wells(CRW) system. Procedures were undertaken with the patient under the local anesthesia for biopsy(78 procedures), cyst aspiration and/or Ommaya reservoir insertion(9 procedures), and brachytherapy(5 procedures) and under the general anesthesia for stereotactic-guided microsurgery(2 procedures). Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 8.5%(8 of 94 procedures). The postoperative complications were transient and not seriour, except aggravation of obstructive hydrocephalus in two cases of lateral ventricular tumors. Specific and correct histological diagnoses were achieved in 73(94%) of 78 biopsy. We could not obtain a specific diagnosis in 3 cases(2 cases of reactive gliosis, 1 case of necrosis). And in two cases with a diagnosis of anaplastic astrocytoma and oligodendroglioma grade I on the basis of surgical specimens by craniotomy, stereotactic biopsy revealed astrocytoma grade II and nonspecific inflammation respectively. Our data suggest that CT-guided stereotactic biopsy is a reliable and safe method for histologic diagnosis of brain-tumoral conditions and the method of choice for deep-seated and midline lesions.

CT-Guided Stereotaxis of Intracranial Mass Lesions: Its Complications and Diagnostic Accuracy of Biopsy

Surgical resection may not be the appropriate first treatment for all intracranial mass lesions, especially for deep or midline lesions. And a precise histopathological diagnosis is mandatory to develop adequate and specific treatments. The advent of modern imaging and CT-compatible stereotactic frames has greatly simplified the performance of streotactic procedure for small and deep seated brain tumors. We present a 44-month experience on 94 stereotactic procedures of intracranial mass lesions, using Brown-Roberts-Wells(BRW) and Cosman-Roberts-Wells(CRW) system. Procedures were undertaken with the patient under the local anesthesia for biopsy(78 procedures), cyst aspiration and/or Ommaya reservoir insertion(9 procedures), and brachytherapy(5 procedures) and under the general anesthesia for stereotactic-guided microsurgery(2 procedures). Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 8.5%(8 of 94 procedures). The postoperative complications were transient and not seriour, except aggravation of obstructive hydrocephalus in two cases of lateral ventricular tumors. Specific and correct histological diagnoses were achieved in 73(94%) of 78 biopsy. We could not obtain a specific diagnosis in 3 cases(2 cases of reactive gliosis, 1 case of necrosis). And in two cases with a diagnosis of anaplastic astrocytoma and oligodendroglioma grade I on the basis of surgical specimens by craniotomy, stereotactic biopsy revealed astrocytoma grade II and nonspecific inflammation respectively. Our data suggest that CT-guided stereotactic biopsy is a reliable and safe method for histologic diagnosis of brain-tumoral conditions and the method of choice for deep-seated and midline lesions.