ABSTRACT
We report the clinical and neuroimaging features of a patient with double schwannomas originating from the vagal and vestibular nerves. Such an association seemed unique, and its surgical implications are discussed.
ABSTRACT
The purpose of this study was to investigate the presence of any correlation between recurrent radicular pain during the first six months following first surgery for herniated lumbar intervertebral disc and the amount of lumbar peridural fibrosis as defined by MR imaging. 197 patients who underwent first-time single-level unilateral discectomy for lumbar disc herniation were evaluated in a randomized, double-blind, controlled multicenter clinical trial. Clinical assessments, performed by physicians blinded to patient treatment status, were conducted preoperatively and at one and six months postoperatively. The enhanced MR images of the operative site utilized in the analysis were obtained at six months postoperatively. Radicular pain was recorded by the patient using a validated visual analog pain scale in which 0 = no pain and 10 = excruciating pain. The data obtained at the 6 month time point were analyzed for an association between amount of peridural scars as measured by MR imaging and clinical failure as defined by the recurrence of radicular pain. The results showed that the probability of recurrent pain increases when scar score increases. Patients having extensive peridural scar were 3.2 times more likely to experience recurrent radicular pain than those patients with less extensive peridural scarring. In conclusion, this prospective, controlled, randomized, blinded, multicenter study has demonstrated that there is a significant association between the presence of extensive peridural scar and the occurrence of recurrent radicular pain.
Subject(s)
Cicatrix/diagnosis , Diskectomy , Dura Mater/pathology , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/surgery , Magnetic Resonance Imaging , Postoperative Complications/diagnosis , Radiculopathy/diagnosis , Adolescent , Adult , Cicatrix/prevention & control , Double-Blind Method , Female , Fibrosis , Gels , Humans , Intervertebral Disc Displacement/diagnosis , Lumbar Vertebrae/pathology , Male , Middle Aged , Pain Measurement , Postoperative Complications/prevention & control , Prospective Studies , Radiculopathy/prevention & control , Recurrence , Tissue Adhesions/diagnosis , Tissue Adhesions/prevention & controlABSTRACT
The expression of complement regulatory proteins (CRP) on the surface of neoplastic cells has been proposed as a mechanism by which these cells evade immune surveillance. We have examined the RNA expression of the genes that encode 5 kinds of CRP in various human brain tumors to determine whether CRP expression might play a role in the malignant progression of these tumors. The benign and atypical meningiomas, and the astrocytomas showed high expression of SP-40,40, low expression of CD59, and barely detectable expression of CD46, CD55 and S-protein. The benign and atypical menigiomas showed significantly greater expression of SP-40,40 at the RNA level when compared to malignant meningiomas. This study describes the mRNA expression of meningiomas, astrocytomas, tumor cell lines and normal human tissues.
