ABSTRACT
A case of pineal area tuberculoma revealed by grand mal seizures and deterioration of vision is presented. A surgical biopsy and chemotherapy produced good results. This unusual site of tuberculoma demonstrates the usefulness of a direct approach to pineal area masses. It also confirms the effectivity of chemotherapy for tuberculoma.
Subject(s)
Pineal Gland/pathology , Tuberculoma/pathology , Tuberculosis, Meningeal/pathology , Adult , Antitubercular Agents/therapeutic use , Biopsy , Diagnosis, Differential , Drug Therapy, Combination , Humans , Male , Tomography, X-Ray Computed , Tuberculoma/drug therapy , Tuberculosis, Meningeal/drug therapyABSTRACT
A case of massive cerebral aspergillosis complicating a frontal encephalomeningocele is reported. The etiology and pathogenesis are discussed and the diagnosis, symptoms, and treatment possibilities reviewed.
Subject(s)
Aspergillosis/etiology , Brain Diseases/etiology , Encephalocele/surgery , Meningocele/surgery , Postoperative Complications , Aspergillosis/drug therapy , Aspergillus fumigatus , Brain Diseases/drug therapy , Child, Preschool , Griseofulvin/therapeutic use , Humans , MaleABSTRACT
The leptomeninges of cats were exposed to lidocaine, metrizamide and methiodal sodium and compared with control brains exposed to Ringer's solution. As a sign of blood-brain barrier damage, an increased extravasation of albumin into the cerebral cortex was recorded after exposure to methiodal sodium; lidocaine or metrizamide did not produce such damage. Scanning electron microscopy revealed minor cellular reactions in the mesothelial cells of the leptomeninges after application of metrizamide, lidocaine and Ringer's solution. Methiodal sodium produced an extensive cellular damage of the leptomeningeal cells. The importance of testing the leptomeningeal reactions and the reactions of the blood-brain barrier to all liquid media used on the brain surface is emphasized.
Subject(s)
Arachnoid/drug effects , Blood-Brain Barrier/drug effects , Lidocaine/pharmacology , Mesylates/pharmacology , Metrizamide/pharmacology , Pia Mater/drug effects , Animals , Arachnoid/ultrastructure , Cats , Female , Male , Microscopy, Electron , Pia Mater/ultrastructure , Serum Albumin, Bovine/metabolismABSTRACT
The mesothelial cell integrity of the subdural and arachnoid surfaces in the cat was investigated by scanning electron microscopy after exposure to different irrigation fluids used in neurosurgery, as well as after drying by air. Irrigation for 3 hours with Elliott's Solution B and Ringer's solution retained the morphology of the cells. After exposure to saline for the same time, the mesothelial cells appeared perforated and were sometimes detached from the underlying connective tissue. Exposure to air for 15 minutes induced extensive, probably irreversible, cell damage. After 5 minutes of exposure to hydrogen peroxide, most cells disappeared, revealing the underlying collagenous connective tissue. These mesothelial cell changes might be one cause of the formation of postoperative subdural adhesions. In previous studies, disturbance of the blood-brain barrier was produced by those agents causing mesothelial cell damage. With hydrogen peroxide, widespread thrombosis occurred in leptomeningeal vessels supplying the cortex. Changes in these vessels can obviously be induced easily by fluids applied to the subdural space because of the close contact between the arachnoid and the adventitia of the vessels. This alternative should be considered in the treatment of cerebral vasospasm.
