ABSTRACT
The characteristics of spinal epidural cavernous hemangioma without primary origin in the vertebral bone were evaluated in 54 patients including our new case. The 36 male and 18 female patients were aged 5 to 78 years (mean 47 years). Most lesions were in the thoracic spine (80%) and on the dorsal side of the spinal cord (93%). The clinical course was mostly slowly progressive, with myelopathy in 33% at onset and 83% at admission. The lesion appeared isointense to the spinal cord on T1-weighted imaging, and isointense or slightly hypointense to the cerebrospinal fluid on T2-weighted imaging. Lesion without hemorrhage showed prominent homogeneous enhancement after administration of gadolinium-diethylenetriaminepenta-acetic acid because of the sinusoidal channel structure. Heterogeneous enhancement was caused by hematoma and/or post-hemorrhagic degeneration. The differential diagnosis of this disease includes metastatic tumor, Ewing's sarcoma, chordoma, eosinophilic granuloma, sarcoidosis, lipoma, hypertrophy of the posterior longitudinal ligament or the ligamentum flavum, meningioma, and neurinoma. The relationships between clinical course and surgery or outcome suggest that early diagnosis and total removal of the lesion before massive lesional bleeding occurs are necessary for a good outcome.
Subject(s)
Epidural Neoplasms/diagnosis , Epidural Neoplasms/surgery , Hemangioma, Cavernous, Central Nervous System/diagnosis , Hemangioma, Cavernous, Central Nervous System/surgery , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle AgedABSTRACT
A method of induction of moderate hyperthermia with a plate heater and a direct current energy source was investigated in the VX-2 rabbit sarcoma model. The theoretical distribution of temperature in the rabbit brain was calculated under various heating conditions. The calculated temperatures coincided well with the temperatures of moderate hyperthermia measured by a thermocouple to a depth of 7 mm under the heater. Moderate hyperthermia was induced in the VX-2 sarcoma. Hyperthermia at 40 degrees C for 20 minutes caused no changes in the lesion. Hyperthermia at 45 degrees C for 20 minutes destroyed the lesion partially to a maximum depth of 3 mm. Hyperthermia at 50 degrees C for 20 minutes caused greater destruction, but also caused edema in the lesion and the surrounding normal brain. Hyperthermia at 55 degrees C for 20 minutes caused severe damage in both the lesion and the surrounding normal brain. Comparison of the actual destruction by hyperthermia and the theoretical temperature distribution indicated that hyperthermia at 43 degrees C for 20 minutes was effective against brain tumor, and destruction reached at least 3 mm from the heater.
