ABSTRACT
Intracranial fibromuscular dysplasia (IFMD) is a rare angiopathy of unknown origin primarily affecting children and young women. We report here on two cases of IFMD; the patients, two females, aging 29 and 25 years, suffered from acute, complete stroke. In one of them emergency extra-intracranial by-pass was attempted without evidence of positive influence on the patient's outcome. In both patients angiography showed the pathognomonic sign of "string of bead" at the level of intracerebral arteries. Cases of IFMD previously reported in the literature are then reviewed and etiology, clinical presentation, pathology, diagnosis and possible treatment of this rare disease are discussed.
Subject(s)
Arterial Occlusive Diseases , Cerebral Arterial Diseases , Fibromuscular Dysplasia , Adult , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/surgery , Cerebral Angiography , Cerebral Arterial Diseases/diagnostic imaging , Cerebral Arterial Diseases/surgery , Female , Fibromuscular Dysplasia/diagnostic imaging , Fibromuscular Dysplasia/surgery , HumansABSTRACT
Seven cases of supratentorial meningiomas are reported. CT-Scan showed irregular hypo-hyperdense zones and features of intratumoral cysts. At surgery a well circumscribed tumor has always been found and easily removed "en bloc". In two cases stereotaxic biopsy was performed previously. CT-Scan findings of meningiomas with microcystic structure and/or necrotic areas may mimic a malignant glioma and lead to an incorrect presumptive diagnosis: then, both therapy and prognosis will be very different. It comes that stereotaxic biopsy is mandatory in all suspected cases of cerebral tumors, in the absence of classical angiographic patterns.
Subject(s)
Glioma/diagnostic imaging , Meningeal Neoplasms/diagnostic imaging , Meningioma/diagnostic imaging , Tomography, X-Ray Computed , Aged , Biopsy , Brain Neoplasms/diagnostic imaging , Cerebral Angiography , Cysts/diagnostic imaging , Diagnosis, Differential , Female , Humans , Middle Aged , Stereotaxic TechniquesABSTRACT
Forty-seven patients with posterior fossa tumours underwent continuous monitoring of intracranial pressure (ICP) in the early postoperative period by means of an intraventricular catheter. ICP values were very low on the day of operation and subsequently became normal in 37 patients. ICP values were raised in 10 patients. The relationship between the ICP and the clinical course was investigated. Patients were subdivided according to the clinical postoperative course into three groups: good, temporarily deteriorated, poor clinical course. The two first groups showed lower values in the ICP than he third one, nevertheless the relationship between the ICP and the postoperative clinical course is marked but not strict. Our data may have some clinical relevance for the treatment of hydrocephalus before extirpation of posterior fossa tumours.
Subject(s)
Brain Neoplasms/surgery , Hydrocephalus/diagnosis , Intracranial Pressure , Adolescent , Adult , Child , Cranial Fossa, Posterior , Female , Humans , Male , Meningeal Neoplasms/surgery , Meningioma/surgery , Middle Aged , Neuroma, Acoustic/surgery , Postoperative Complications/diagnosis , PrognosisSubject(s)
Hematoma, Epidural, Cranial/diagnosis , Adolescent , Child , Child, Preschool , Chronic Disease , Female , Humans , MaleABSTRACT
Some cases of chronic subdural haematomas (in patients aged from 17 to 27 years) with unusual symptomatology and difficult diagnosis are presented. The usefulness of cerebral scintigraphy which can clarify any diagnostic doubt and lead to a right neuroradiological behaviour is underlined.
