Giant cervico-thoracic schwannoma with long clinical history. Case report.

An unusual case of a giant intraspinal schwannoma in a 45-year-old woman with 14-year history of preoperative symptoms was presented. MRI of the spine revealed an intradural, extramedullary tumor extending from the intervertebral space C4/C5 to T4 vertebral body level (2 x 1.2 x 12 cm) and filling almost the entire spinal canal. Microscopical examination showed a typical neurinoma pattern with two distinct zones of Antoni A and Antoni B tissue. Some areas exhibited nuclear atypia and hyperchromasia reflecting the degenerative changes in this slowly growing nerve sheath tumor. A rich pericellular reticulin network was seen in the areas composed of Antoni A tissue. Immunohistochemically, the tumor cells were strongly positive for S-100 protein. The diagnostic difficulties in the presented case of longstanding schwannoma resulted in the late surgical treatment. The importance of the early diagnosis of spinal nerve sheath tumors for the patient's quick recovery is stressed.

[Value of rheographic studies in the diagnosis of epileptogenic foci in temporal lobe epilepsy]. / Wartosc badan reograficznych w diagnostyce ogniska padaczkorodnego w padaczce skroniowej.

Using a type II Siemens rheograph 100 patients with temporal lobe epilepsy aged 18--36 years were investigated. In each case rheographic investigation was done in sitting and lying position, at rest and after hyperventilation in both these positions. The shape of the descending arm of the main wave of the averaged rheoencephalographic curve was analysed in detail. In 89 cases unilateral presence of h1 wave was found, which was absent in the rheograms of healthy subjects, and h2 wave was present also. The shape of the remaining rheographic curves in this population was not different from the records obtained in healthy subjects. In 92 patients EEG investigations demonstrated focal changes were found, in 8 bilateral changes were present, prevalent on one side. In 85 cases h waves were present on the side of the epileptogenic focus, and in 4 cases it was present contralaterally but only in patients with bilateral EEG changes. The results of these investigations point to differences in the haemodynamic conditions in the temporal lobes in healthy subjects and in most patients with temporal lobe epilepsy on the side of the epileptogenic focus. Rheographic investigations was found to be useful for determination of the side of the epileptogenic focus.

[Analysis of the rheoencephalographic curves from the temporal areas in healthy subjects aged 18-22 and obtained by means of type II rheography]. / Analiza krzywych reoencefalograficznych z okolic skroniowych u ludzi zdrowych w wieku 18--28 lat, wykonana przy pomocy reografii typ II.

Using Siemens type II rheograph 100 subjects aged 18 to 28 years were investigated analysing averaged rheoencephalographic curves from 50 repetitions by means of a Neuro-Averager apparatus made by Biomedica, and Anops 10 Biological Computer. The trigger for averaging was the QRS complex in ECG of the investigated subject. The records were obtained in sitting and lying positions. All curves were divided into the following types: U waves, U--W waves and W waves; positive and negative curves were also separated. The segment between the peak of the main wave and the beginning of the dicrotic wave was subjected to a particularly careful analysis. Because of its shape and accessory waves occurring there they were divided into alpha and beta waves. In the group of W waves L waves were separated. In sitting position 70% of the waves belonged to group W and positive waves were observed in 98% of this group. In lying position W waves accounted for 61% and positive waves for 12%. The shape of REG wave reflects the haemodynamic conditions in a given area and is changed, similarly as these conditions, with a change in the position of the subject.

[Comparison between thiopental and brietal in the activation electrocorticographic records in epileptics]. / Porównanie aktywacji pentotalem i brietalem zapisów elektrokortykograficznych w padaczce.

For activation of electrocorticographic records the authors administered intravenously thiopental or Brietal to 86 patients undergoing operations for various types of focal epilepsy. Thiopental was administered either in intravenous drip infusion as 0.2% solution, or in a single injection of 2.5% solution. Brietal was injected as 1% solution intravenously. Thiopental activated electrocorticographic tracings in 56.3% and Brietal in 84% of the patients. In the conclusions the authors stress that both these agents may be used for activation of pathological discharges in ECoG in patients with epilepsy operated upon under general anaesthesia. Brietal seems to be better and it may be administered many times.