[Uncommon presentation of central neurocytoma causing intraventricular hemorrhage: case report]. / Neurocitoma central com apresentação incomum por hemorragia intraventricular: relato de caso.

Central neurocytoma was first described by Hassoun et al. in 1982 as a well-differentiated tumor from neuronal origin. This tumor typically occurs in young adults, localized in the ventricular system. It usually presents as intracranial hypertension due to obstructive hydrocephalus. The differential diagnosis should be done with others intraventricular tumors as oligodendroglioma, subependymoma and choroidal plexus papilloma. There are few cases of central neurocytoma presented by intraventricular hemorrhage in the literature. We report a case of 35 year-old woman, who presented with obstructive hydrocephalus due to intraventricular hemorrhage within the tumor. MRI revealed a tumor localized in the right lateral ventricle. Histopathological and immunohystochemical analysis confirmed the diagnosis of central neurocytoma. We review options for the treatment of this entity as well reinforce the inclusion of central neurocytoma as a differential diagnosis for intraventricular hemorrhage.

Multiple brain abscesses caused by Salmonella typhi: case report.

BACKGROUND: Focal intracranial infections caused by Salmonella species are uncommon. The authors report a case of multiple brain abscesses caused by Salmonella typhi. CASE DESCRIPTION: A 2-month-old girl was admitted to the hospital because of diarrhea, vomiting, fever, and poor feeding. Neurological examination revealed cervical hyperextension and absence of sucking and Moro reflexes. During the next 20 hours she developed complex partial seizures with secondary generalization and alternated irritability with drowsiness. Investigation showed hemoglobin 6.3 g/dl; white blood cell count of 19500/mm3 with a marked shift to the left. The analysis of the cerebrospinal fluid revealed white cell count of 1695/mm3, lymphocytes 61%, protein 300 mg/dl and glucose 6 mg/dl. The patient was treated for acute gastroenterocolitis, sepsis, and meningitis. Blood culture taken on the day of admission showed gram-negative bacilli, later identified as S. typhi. Computed tomography scan demonstrated a lesion in the right parietal lobe compatible with a brain abscess. Follow-up computed tomography after 7 days showed several other lesions with the same features. Surgical drainage of the right parietal lesion was performed on the 13th day, through a burr hole. The patient was discharged 5 weeks after admission without neurological deficit. CONCLUSION: Bacteremia, sepsis, and meningitis are relatively common in children with Salmonella infection but intracranial abscesses are very rare. Surgical drainage combined with prolonged antibiotic therapy (drug of choice: chloramphenicol) is the best treatment for Salmonella brain abscesses. The possibility of intracranial infection should be considered in patients with Salmonellosis and neurological dysfunction.

[Pilocytic astrocytoma in childhood: presentation of six cases]. / Astrocitoma pilocítico na infância: apresentação de seis casos.

OBJECTIVE: To present 6 cases of pilocytic astrocytomas whose clinic, epidemiological and histopathological aspects were studied. METHODS: Between 1990 and 1994 the records of the laboratories of pathology of the main hospitals in Curitiba were analysed and all cases of pilocytic astrocytomas were studied with special attention to age of onset, sex and site of the lesions. The biopsies, which were reviewed, have been processed according to conventional techniques and in a few cases electron microscopy and immunohistochemistry was further done. RESULTS: Five patients were females and 1 was male. Medium age was 4,5 years (range 1-8). The pilocytic astrocytomas affected optic chiasm (n=3), midline of cerebral hemisfere (n=2) and third ventricle (n=1). The symptoms reflected the location and extension of the tumour. The commonest signs and symptoms were those of intracranial hypertension, visual disturbances, hydrocephalus, among others. The patients were treated with surgical ressection and chemotherapy. Three patients died after a medium survival of 45 days, and three remain alive. CONCLUSIONS: The authors emphasize that pilocytic astrocytoma, mainly the juvenile variant, affect mostly the midline brain structures of infants through signs of visual disturbance. These lesions are low grade astrocytomas and should be treated predominantly by total surgical ressection.