[Malignant course of a ganglioglioma: case report]. / Evolução maligna de um ganglioglioma. Relato de caso.

We present the case of a 8-years-old boy, admitted with a history of headache, nausea and vomiting. Cerebral angiography showed a non-vascular mass on frontal lobe. The patient underwent craniotomy and the lesion was removed. Neuropathological study revealed that the tumor was a ganglioglioma. The patient received pos-operative radiotherapy. On follow-up, 16 years after, a computed tomographic scan showed a recurrence of the tumor, and a second surgery revealed a glioblastoma multiform. Gangliogliomas are rare tumors of the central nervous system containing neoplastic ganglion cells and low grade neoplastic glial cells. The malignant degeneration occurs only in the glial component, so the prognosis of these tumors is related to the grade of that component.

[Brain metastasis of malignant melanoma. Analysis of 13 cases]. / Melanomas metastáticos intracranianos. Análise de 13 casos.

The authors present a retrospective review of 13 patients with the diagnostic of intracranial metastatic malignant melanoma. Their ages ranged from 28 to 84 years. The time interval from diagnosis of primary tumor to development of cerebral metastases ranged from 6 to 60 months. There was preoperative evidence of extracranial disease in 9 patients. All patients underwent craniotomy, and the 30-day mortality was zero. The patients survived 2 to 55 months after surgery. Medium survival time for all patients was 14 months. The excision of metastatic melanoma from the brain, although not curative, may increase survival in patients with this metastatic cancer. The criteria for consideration of surgery, radiotherapy and chemotherapy are discussed.

[Giant intracranial aneurysm in a 9 year-old child. Case report]. / Aneurisma intracraniano gigante em criança de nove anos. Relato de caso.

The case of a 9-year-old girl with intracranial hemorrhage due to a giant aneurysm of distal middle cerebral artery is reported. Cerebral aneurysms are rare in children, particularly in the first decade of life. Aneurysms in childhood occur more frequently in peripheral branches and they are more often giant in size. Clinical features and pathogenesis of this lesion are discussed.

[Benign chondroblastoma of the occipital bone. A case report]. / Condroblastoma benigno do osso occipital. Relato do caso.

Benign chondroblastoma is a rare bone tumor of immature cartilage cell derivation. This lesion classically occur at the ends of long bones in young persons. Chondroblastoma arising from the occipital bone is extremely rare. We report the case of a 16 year old girl with a benign condroblastoma in the occipital bone, and discuss the clinical, radiological and treatment aspects of this tumor.

[Thoracic epidural angiolipoma. Report of a case]. / Angiolipoma epidural torácico. Relato de caso.

Angiolipomas of the spine are rare (40 cases in the literature). When they are intraspinal, these masses are epidural in more than 90% of the cases. Angiolipomas are benign tumors containing vascular and mature adipose elements. The clinical symptomatology is non specific, but computed tomography and mostly MRI provide a precise diagnosis. With one additional case and a review of the literature, we define the main characteristics of these tumors.

[Carpal tunnel syndrome: retrospective study of 106 cases and complications]. / Síndrome do túnel do carpo: estudo retrospectivo de 106 casos e complicações.

The authors present a short review of anatomic and pathophysiological bases of the carpal tunnel syndrome, and its surgical treatment and complications. They report the cases of two patients who developed sympathetic alterations with hand edema and vascular changes (Raynaud phenomenon), and propose an explanation which they name "sympathetic denervation". This is the only complication of their series and it occurred during the immediate post-operative period, coinciding with removal of immobilization of the wrist on the 22nd post-operative day.

[Cystic meningioma]. / Meningiomas císticos.

Cystic meningiomas are uncommon lesions. CT image may simulate a glial or a metastatic tumor with cystic or necrotic changes. The correct radiological evaluation and the recognition of this kind of tumor are important for surgical treatment since they are potentially curable neoplasms. In this paper the authors report their experience with the treatment of three cases of cystic meningiomas, and discuss some characteristics of these lesions.

[Traumatic diabetes insipidus: a case report]. / Diabetes insipidus traumático: relato de caso.

This case report refers to a thirty-nine years old female patient with severe head injury and other body injuries who developed symptoms of diabetes insipidus. The patient died eleven days after hospital admission during which magnetic resonance imaging and computerized tomography were done, showing characteristic hypothalamic lesions. This stimulated the authors to review the literature and call attention to the prevention and prognosis of endocrine syndromes which may appear in patients secondarily and late, and whose morbidity may be decreased with early diagnosis and treatment.

[Air in extradural hematoma: report of 2 cases]. / Ar em hematomas extradurais: relato de dois casos.

The authors report two cases of the presence of free air in acute extradural hematomas. This is not an unusual radiological finding which has been infrequently reported in the literature.

Síndrome do túnel do carpo: estudo retrospectivo de 106 casos e complicaçöes / Carpal tunnel syndrome: retrospective study of 106 cases and complications

Fazemos breve revisäo das bases anatômicas e fisiopatológicas da síndrome do túnel do carpo, seu tratamento cirúrgico e suas complicaçöes. Relatamos os casos de duas pacientes que desenvolveram alteraçöes simpáticas como edema da mäo e problemas vasculares (fenômeno de Raynaud) para as quais ensaiamos uma explicaçäo, por nós denominada "denervaçäo, coincidindo com a retirada da imobilizaçäo do punho no 22§ dia pós-operatório

Meningiomas císticos / Cystic meningiomas

A ocorrência de meningiomas císticos é incomum. As imagens destas lesöes obtidas pela tomografia computadorizada de crânio (TC) podem lembrar lesäo cística de origem glial ou metastática, sendo necessário realizarmos, além da TC, angiografia cerebral e ressonância magnética do crânio para firmarmos diagnóstico correto pré-operatório. O diagnóstico incorreto de glioma pode resultar em tratamento paliativo, ao invés da remoçäo radical desta neoplasia potencialmente curável. Três casos säo relatados, ilustrando o problema

Diabetes insipidus traumático: relato de caso / Traumatic diabetes insipidus: a case report

Trata-se do relato do caso de paciente do sexo feminino, com 39 anos, politraumatizada, que desenvolveu quadro de diabetes insipidus. A paciente faleceu onze dias após sua internaçäo, período em que foram realizadas tomografia computadorizada e ressonância magnética, evidenciando lesöes hipotalâmicas características. Estes fatos nos estimularam revisar a literatura e chamar a atençäo para prevençäo de síndromes endócrinas que podem acometer secundária e tardiamente pacientes vítimas de traumatismo crânio-encefálico e que, se diagnosticadas e tratadas de maneira precoce, podem ter sua morbidade diminuída

Ar em hematomas extradurais: relato de dois casos / Air in extradural hematomas: report of 2 cases

Os autores relatam dois casos de presença de ar livre em hematoma extradural agudo. Trata-se de achado radiológico näo incomúm, mas que tem sido relatado infrequentemente na literatura

[False aneurysm of the median meningeal artery: the importance of angiographic diagnosis. A case report]. / Falso aneurisma da artéria meníngea média. Importância do diagnóstico angiográfico. Relato de caso.

The purpose of this paper is to report a case of false aneurysm of the middle meningeal artery. The authors emphasize the value of "common" carotid angiography in diagnosis and treatment of this rare lesion.

[Extradural hematoma of the posterior fossa. Report of 7 cases]. / Hematoma extradural da fossa posterior. Relato de sete casos.

Hematomas of the posterior fossa are an uncommon complication of head injury. Almost invariably they occur after trauma of the occiput, and are associated with skull fracture. Their diagnosis and management have been greatly improved by CT scanning. In the present series, the majority of patients had acute evolution indicating the potential hazard of conservative treatment. Our results (29% mortality) are similar to those previously reported in other series.

[Multiple meningiomas and neurofibromatosis. Report of 3 cases]. / Meningiomas múltiplos e neurofibromatose. Relato de três casos.

Multiple intracranial meningiomas (MIM) may be a specific pathological entity. In general these lesions are associated with neurofibromatosis. The classical clinical picture of neurofibromatosis, as described by von Recklinghausen, may not necessarily be associated with MIM. This possibility is a direct result of the variable penetrability of chromosomic aberrations connected with the chromosome 22. Molecular studies of these tumors confirmed this finding. In our series of 108 patients with intracranial meningiomas only three cases were multiple. In only one of them external stigmata of von Recklinghausen's disease were detected. In the absence of skin manifestations of neurofibromatosis in patients with MIM it is very difficult to diagnosis von Recklinghausen's disease, and the so called "true multiple meningiomas". The authors believe that there are no justificative findings to consider MIM as an independent pathological entity.

[Cerebral metastasis from prostatic neoplasm simulating meningioma. Report of a case]. / Mestástase cerebral de carcinoma prostático simulando meningioma. Relato de caso.

The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs suggesting meningioma. The literature on the subject is reviewed and summarized.

Mestástase cerebral de carcinoma prostático simulando meningioma / Cerebral metastasis from prostatic neoplasm simulating meningioma

The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs suggesting meningioma. The literature on the subject is reviewed and summarized.

Meningiomas múltiplos e neurofibromatose / Multiple meningiomas and neurofibromatosis

Multiple intracranial meningiomas (MIM) may be a specific pathological entity. In general these lesions are associated with neurofibromatosis. The classical clinical picture of neurofibromatosis, as described by von Recklinghausen, may not necessarily be associated with MIM. This possibility is a direct result of the variable penetrability of chromosomic aberrations connected with the chromosome 22. Molecular studies of these tumors confirmed this finding. In our series of 108 patients with intracranial meningiomas only three cases were multiple. In only one of them external stigmata of von Recklinghausen's disease were detected. In the absence of skin manifestations of neurofibromatosis in patients with MIM it is very difficult to diagnosis von Recklinghausen's disease, and the so called "true multiple meningiomas". The authors believe that there are no justificative findings to consider MIM as an independent pathological entity.

Hematoma extradural da fossa posterior / Extradural hematoma of the posterior fossa

Hematomas of the posterior fossa are an uncommon complication of head injury. Almost invariably they occur after trauma of the occiput, and are associated with skull fracture. Their diagnosis and management have been greatly improved by CT scanning. In the present series, the majority of patients had acute evolution indicating the potential hazard of conservative treatment. Our results (29% mortality) are similar to those previously reported in other series.