Résumé
We report on two cases of microguidewire breakage that occurred during endovascular treatment of intracranial aneurysms. The microguidewire can be broken when a part of the wire is stuck due to vascular tortuosity, and, subsequently, application of excessive rotational movement. The mechanical and physical properties of a microguidewire are also important factors in microguidewire breakage. We also suggest technical tips for avoidance of this problem.
Sujets)
Sujet âgé , Femelle , Humains , Adulte d'âge moyen , Cathéters , Ablation de dispositif , Embolisation thérapeutique/instrumentation , Panne d'appareillage , Anévrysme intracrânien/thérapie , Radiographie interventionnelle/instrumentationRésumé
Intradural lumbar disc herniation(ILDH) is a rare pathology. The pathogenesis of ILDH is not known with certainty. Adhesions between the ventral wall of the dura and the posterior longitudinal ligament(PLL) could act as a preconditioning factor. Diagnosis of ILDH is difficult and seldom suspected preoperatively. Prompt surgery is necessary because the neurologic prognosis appears to be closely related to preoperative duration of neurologic symptoms. Despite preoperatively significant neurological deficits, the prognosis following surgery is relatively good. We report on case of ILDH at L3/4 with differential diagnoses, and the possible pathogenic factors are discussed.
Sujets)
Diagnostic , Diagnostic différentiel , Manifestations neurologiques , Anatomopathologie , Pronostic , RachisRésumé
Nineteen astrocytic neoplasms, such as 9 cases of glioblastoma multiforme, 6 cases of anaplastic astrocytoma and 4 cases of low grade astrocytoma, were analysed in view of the relationship between histopathologic grade, nuclear pleomorphism, grade of mutant p53 gene expression and mean survival time after operation. The histopathologic classification by Ringertz and immunohistochemical stain for mutant p53 gene with the DO-7 anti-p53 oncoprotein mouse monoclonal antibody were applied, and the results obtained were as follows; 1) Among 19 cases, 18 cases were located in the supratentorium, where 13 cases(42%) were located in the left and 17 cases(55%) in the right. 2) The p53 gene expression was detected in 12(63.2%) of the cases, as revealed by positive nuclear staining. All cases of glioblastoma multiforme showed p53 gene expression, compared with two(33.3%) cases of anaplastic astrocytoma and one(25%) case of low grade astrocytoma. The frequency and degree of histopathologic grade(p=0.03). 3) The mean survival time after operation was 29.49+/-4.08 months in cases with p53-negative tumors and 12.93+/-3.14 months in cases with p53-positive tumors(p<0.05). 4) Both histopathological classification and p53 gene expression showed a significant influence on servival(p=0.02 and p=0.03, respectively). 5) The relative risk for survival time was the highest in p53 gene expression. In conclusion, p53 gene expression appears to be one of the recommendable prognosticators among astrocytic neoplasms.
Sujets)
Animaux , Souris , Astrocytome , Classification , Gènes p53 , Glioblastome , Taux de survieRésumé
We describe a case of metastatic alveolar soft part sarcoma of the brain in a 31 year old women. Alveolar soft part sarcoma is rare tumor that occurs mostly in the extremities and have a high incidence of blood born metastasis. Cerebral metastasis may be the first manifestation of the disease. The histogenesis of alveolar soft part sarcoma remains uncertain. The primary therapeutic option is aggressive surgical excision. Survival even with the development of metasrasis can be long.