ABSTRACT
Brain stem gliomas are a heterogeneous group of neoplasms arising mostly in paediatric patients. Tectal plate gliomas represent a particular type of brain stem tumours usually with a benign, indolent clinical course, presenting with signs of raised intracranial hipertension due to supra-tentorialhydrocephalous caused by aqueductal stenosis. Seldom high-grade lesions arise in this location with tremendous therapeutic implications. When a malignant tumour is clinically and radiographically suspected a biopsy should be performed to obtain histhological confirmation. Treatment is then planned in a case-by-case basis. We present the case of a glioblastoma of the tectal plate in a 22 years-old woman operated upon by a supracerebellar-infratentorial approach.
Os gliomas do tronco cerebral são um grupo heterogêneo de neoplasias que acometem habitualmente crianças. Os gliomas da placa quadrigeminal representam um tipo particular de tumores do tronco cerebral, habitualmente com um curso benigno e indolente, surgindo com sinais de hipertensão intracraniana devido a hidrocefalia supra-tentorial provocada por compressão do aqueduto cerebral. Raramente surgem lesões de alto grau nesta região, mas as implicações terapêuticas são tremendas. Quando existe suspeita clínica e imagiológica de que se trata de lesão maligna, esta deve ser biopsada para se obter confirmação histológica. O tratamento deve então ser planejado caso a caso. Apresentamos o caso de glioblastoma da placa quadrigeminal em uma paciente de 22 anos intervencionado por via supracerebelar-infratentorial.
Subject(s)
Adult , Female , Humans , Brain Neoplasms , Glioblastoma , Tectum Mesencephali , Brain Neoplasms/diagnosis , Brain Neoplasms/surgery , Follow-Up Studies , Glioblastoma/diagnosis , Glioblastoma/surgery , Magnetic Resonance Imaging , Tectum Mesencephali/surgeryABSTRACT
Male Wistar rats were decerebrated at precollicular level, by aspiration under ether anaesthesia. The experiments employed rats instrumented for chronic electrocardiogram (ECG) recordings or mean blood pressure (MBP) and heart rate (Hr) determination. Immediately after surgery, decerebrate (D) and sham operated (SO) animals presented a small and ismilar increase in their HR. Three and a half hours after surgery, SO group presented a normal HR, whilst D animals continued to show an increas ein their HR up to 4.5 h, when it stabilized. Twenty four hours after surgery both groups presented similar MBP (D:110ñ6; SO:108ñ11; SO:335ñ5 beats/min). The blockade of parasympathetic tonus induced significant increases in the HR of both groups, withou major changes in their MBP. Beta-adrenergic blockade reduced HR of both groups, bringin HR of D almost to control level. Simultaneously there was a reduction in MBP of D but not of SO animals. When parasympathetic blockade was superimposed to beta-adrenergic blockade, there was a significant increase in HR of SO, but not of D or in MBP of both groups. Thus we conclude that the decerebrate rat presents normal MBP with simultaneous tachycardia mainly caused by increased sympathetic outflow to the heart