ABSTRACT
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Subject(s)
Humans , Female , Adult , Arachnoiditis/etiology , Lumbosacral Region , Peritoneovenous Shunt/adverse effects , Pseudotumor Cerebri/surgery , Risk FactorsABSTRACT
BACKGROUND: Intraventricular meningiomas are rare tumours that represent about 2% of all intracranial meningiomas, and represent one of the most challenging problems in neurosurgery. They are located deep within the brain and often are sizable and highly vascular. We report on a series of 10 meningiomas of the lateral ventricles treated at our institution during the last 28 years. PATIENTS: Ten patients (6 women, 4 men; mean age 41.6 yrs) were admitted to our medical center between 1978-2005 with meningioma of the lateral ventricles. Headache was the first symptom in 8 cases and ocular signs were present in 5 patients. RESULTS: Seven tumours were located in the right ventricle (70%) ranging in size from 2-8 cm, with 7 tumours larger than 3 cm in diameter. Nine patients underwent surgery with total excision in 8 cases and subtotal in the other; the remaining patient only received radiosurgery. CONCLUSIONS: Total resection is the gold standard for treatment which was possible in all but one of the cases undergoing surgery.
Subject(s)
Cerebral Ventricle Neoplasms/pathology , Lateral Ventricles/pathology , Meningioma/pathology , Adolescent , Adult , Cerebral Ventricle Neoplasms/physiopathology , Cerebral Ventricle Neoplasms/surgery , Child , Female , Humans , Lateral Ventricles/surgery , Magnetic Resonance Imaging , Male , Meningioma/physiopathology , Meningioma/surgery , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Background. Intraventricular meningiomas arerare tumours that represent about 2% of all intracranialmeningiomas, and represent one of the most challengingproblems in neurosurgery. They are locateddeep within the brain and often are sizable and highlyvascular. We report on a series of 10 meningiomas of thelateral ventricles treated at our institution during thelast 28 years.Patients. Ten patients (6 women, 4 men; mean age41.6 yrs) were admitted to our medical center between1978-2005 with meningioma of the lateral ventricles.Headache was the first symptom in 8 cases and ocularsigns were present in 5 patients.Results. Seven tumours were located in the rightventricle (70%) ranging in size from 2-8 cm, with 7tumours larger than 3 cm in diameter. Nine patientsunderwent surgery with total excision in 8 cases andsubtotal in the other; the remaining patient only receivedradiosurgery.Conclusions. Total resection is the gold standard fortreatment which was possible in all but one of the casesundergoing surgery (AU)
Introducción. Los meningiomas intraventricularesson neoplasias poco frecuentes que constituyen alrededordel 2% de todos los meningiomas intracraneales.Pacientes y métodos. Revisamos 10 pacientes (6mujeres, 4 varones; media de edad: 41.6 años) diagnosticados en nuestro servicio de neurocirugía entre 1978-2005 de meningioma de ventrículo lateral.Resultados. El síntoma de debut fue la cefalea en 8casos y en 5 pacientes existían alteraciones oculares.Siete tumores estaban localizados en el ventrículo derecho(70%) con un tamaño que oscilaba entre 2 y 8 cm.;7 tumores tenían más de 3 cm. de diámetro. Se intervinoquirúrgicamente a 9 pacientes consiguiéndose unaextirpación completa en 8 casos y subtotal en el otro;el paciente restante fue tratado mediante radiocirugíaestereotáctica.Conclusiones. La resección completa es el tratamientoidóneo en los meningiomas intracraneales, queexceptuando un caso fue posible en todos nuestrospacientes operados (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Cerebral Ventricle Neoplasms/diagnosis , Cerebral Ventricle Neoplasms/surgery , Meningioma/diagnosis , Meningioma/surgery , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Magnetic Resonance ImagingABSTRACT
INTRODUCTION: Thalamic tumours account for approximately 1% to 5% of all brain tumours, and are usually unilateral astrocytoma and frequently affect children. Bilateral thalamic tumours are very rare neoplasm, yet their actual incidence is unknown. AIMS: To report three children with bilateral thalamic tumours diagnosed in a 20 years period and to review the previously reported cases. CASE REPORTS: Here we report three children with bilateral thalamic tumours and review the previously reported cases diagnosed by angiography, computed tomography, and or magnetic resonance imaging. Twenty-six patients with bilateral thalamic tumours were analysed (13 children and 13 adults). Symptoms of mental impairment were present in 13 cases (50%) and sings of intracranial hypertension in 7 (26.9%). The pathology was confirmed in 22 patients (12 low grade gliomas and 10 high grade gliomas). In paediatric age there was a slight preponderance of low grade gliomas (7/12). The mean survival is 12.3 months (range: 7-36 months). CONCLUSIONS: Bilateral thalamic tumours are exceptional and have radiological and clinical features that differ from those of unilateral thalamic tumours. Today, the main role of surgery is still to obtain a histological diagnosis. The outcome of treatment for bilateral thalamic tumours remains poor, with only 7.6% of all patients surviving for more 12 months.
Subject(s)
Brain Neoplasms/pathology , Thalamus/pathology , Adolescent , Brain Neoplasms/diagnosis , Child , Child, Preschool , Fatal Outcome , Female , Humans , Male , Review Literature as Topic , Survival RateABSTRACT
Los tumores talámicos constituyen entre el 1 y el 5% de todos los procesos expansivos intracraneales,con frecuencia son de localización unilateral y tienen una mayor incidencia en la infancia. Los tumores talámicos bilaterales son excepcionales y su incidencia exacta no ha sido bien establecida hoy en día. Objetivos. Se presentan tres casos de tumorestalámicos bilaterales en niños y se analizan los casos publicados previamente. Casos clínicos. Se presentan tres casos de tumores talámicos bilaterales en edad pediátrica atendidos en un período de 20 años. Asimismo, se realiza una revisión de los casospublicados y diagnosticados mediante angiografía, tomografía computarizada o resonancia magnética. De la revisión de la bibliografía se analizan 26 casos de tumores talámicos bilaterales (13 niños y 13 adultos). Los síntomas predominantes fueron alteración cognitiva en 13 casos (50%) y signos de hipertensión intracraneal en 7 (26,9%). La histología fue confirmada en 22 casos (12 gliomas de bajo grado y 10 de alto grado); en la edad pediátrica existe un ligero predominio de los gliomas de bajo grado (7 a 12). La supervivencia media fue de 12,3 meses (rango: 7-36 meses). Conclusiones. Las neoplasias bitalámicas representan un grupo tumoral con características clínicas y radiológicas diferentes a los tumores unilaterales. La cirugía desempeñaun papel secundario en su tratamiento y se ciñe únicamente a la práctica de una biopsia con objetivo diagnóstico. El pronóstico es malo y sólo el 7,6% de los pacientes sobrevive más de 12 meses
Thalamic tumours account for approximately 1% to 5% of all brain tumours, and are usually unilateralastrocytoma and frequently affect children. Bilateral thalamic tumours are very rare neoplasm, yet their actual incidence is unknown. Aims. To report three children with bilateral thalamic tumours diagnosed in a 20 years period and to review the previously reported cases. Case reports. Here we report three children with bilateral thalamic tumours and review the previouslyreported cases diagnosed by angiography, computed tomography, and or magnetic resonance imaging. Twenty-sixpatients with bilateral thalamic tumours were analysed (13 children and 13 adults). Symptoms of mental impairment were present in 13 cases (50%) and sings of intracranial hypertension in 7 (26.9%). The pathology was confirmed in 22 patients (12 low grade gliomas and 10 high grade gliomas). In paediatric age there was a slight preponderance of low grade gliomas(7/12). The mean survival is 12.3 months (range: 7-36 months). Conclusions. Bilateral thalamic tumours are exceptional and have radiological and clinical features that differ from those of unilateral thalamic tumours. Today, the main role of surgery is still to obtain a histological diagnosis. The outcome of treatment for bilateral thalamic tumours remains poor, with only 7.6% of all patients surviving for more 12 months
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Thalamus/pathology , Brain Neoplasms/pathology , Astrocytoma/pathology , Brain Neoplasms/diagnosis , Tomography, X-Ray Computed , Astrocytoma/diagnosis , Magnetic Resonance SpectroscopyABSTRACT
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Subject(s)
Humans , Epidermal Cyst/diagnosis , Epidermal Cyst/surgery , Fourth Ventricle , Brain Diseases/diagnosis , Brain Diseases/surgeryABSTRACT
BACKGROUND: Intracranial pressure (ICP) monitoring has become standard in the management of neurocritical patients. A variety of monitoring techniques and devices are available, each offering advantages and disadvantages. Analysis of large populations has never been performed. PATIENTS AND METHODS: A prospective study was designed to evaluate the Camino fiberoptic intraparenchymal cerebral pressure monitor for complications and accuracy. RESULTS: Between 1992-2004 one thousand consecutive patients had a fiberoptic ICP monitor placed. The most frequent indication for monitoring was severe head injury (697 cases). The average duration of ICP monitoring was 184.6 +/- 94.3 hours; the range was 16-581 hours. Zero drift (range, -17 to 21 mm Hg; mean 7.3 +/- 5.1) was recorded after the devices were removed from 624 patients. Mechanical complications such as: breakage of the optical fiber (n = 17); dislocations of the fixation screw (n = 15) or the probe (n = 13); and failure of ICP recording for unknown reasons (n = 4) were found in 49 Camino devices. CONCLUSIONS: The Camino ICP sensor remains one of the most popular ICP monitoring devices for use in critical neurosurgical patients. The system offers reliable ICP measurements in an acceptable percentage of device complications and the advantage of in vivo recalibration. The incidence of technical complications was low and similar to others devices.
