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1.
Interv Neuroradiol ; 16(3): 317-21, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20977867

RESUMO

Non-traumatic subgaleal hematoma is very rare. We present a case of refractory non-traumatic subgaleal hematoma occurring in a 15-year-old male patient. The patient was successfully treated by embolization of the superficial temporal artery. This therapeutic approach to refractory non-traumatic subgaleal hematoma is discussed.


Assuntos
Embolização Terapêutica , Hematoma Epidural Craniano/diagnóstico por imagem , Hematoma Epidural Craniano/terapia , Artérias Temporais/diagnóstico por imagem , Adolescente , Angiografia Cerebral , Humanos , Masculino , Tomografia Computadorizada por Raios X , Curetagem a Vácuo
2.
Clin Neuropathol ; 28(2): 96-100, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19353840

RESUMO

OBJECTIVE: Radiation-induced tumors are a rare complication of radiation therapy. Here, we describe the first case of a radiation-induced osteosarcoma with a rhabdomyosarcoma component arising from the dura mater after radiation therapy for an astrocytoma. PATIENT: An 18-year-old man with generalized seizures presented with a neoplastic lesion in the dura mater of a previously irradiated (56 Gy) region 5 years after the initial radiation therapy. A tumor resection was performed, and histological examination revealed an osteosarcoma with a rhabdomyosarcoma component. The tumor recurred despite eight tumorectomies and the addition of chemotherapy and radiotherapy. The patient died from tumor progression 5 years after the first surgical removal of the radiation-induced tumor. CONCLUSION: This radiation-induced tumor may have originated from primitive, multipotent mesenchymal cells, as it included both osteosarcoma and rhabdomyosarcoma components.


Assuntos
Astrocitoma/radioterapia , Dura-Máter , Neoplasias Meníngeas/patologia , Neoplasias Induzidas por Radiação/patologia , Osteossarcoma/etiologia , Rabdomiossarcoma/etiologia , Rabdomiossarcoma/patologia , Adolescente , Astrocitoma/patologia , Encéfalo/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/radioterapia , Osteossarcoma/patologia , Planejamento da Radioterapia Assistida por Computador
3.
Minim Invasive Neurosurg ; 51(6): 329-32, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19061142

RESUMO

OBJECTIVE: When the bone flap is removed in a pterional craniotomy, the middle meningeal artery (MMA) should be gently dissected to minimize blood loss. However, when the MMA pierces a bony tunnel in the middle meningeal groove it is easily damaged upon bone flap elevation. We have performed an anatomic study of this tunnel to render pterional craniotomy safer. METHODS: We examined 78 sides from 39 adult skulls for the presence and length of the tunnel, the distance between the lateral border of the superior orbital fissure and the proximal part of the tunnel, and examined the relationship between the MMA piercing the tunnel to a surface landmark, i.e., the junction of the sphenoparietal, sphenosquamosal, and squamosal sutures. RESULTS: We found 59 tunnels on 78 sides (75.6%); 2 were at the branching of the MMA on one side. The tunnels were located on the temporal side of the lesser wing of the sphenoid bone. The length of the tunnel and the distance from the superior orbital fissure were 3-23 mm (mean: 12.2 mm) and 11-33 mm (mean: 18.9 mm), respectively. Most tunnels (86.4%) were bilateral; in 67.8% of the specimens the MMA piercing the tunnel was just beneath the surface landmark. CONCLUSION: As we found a high incidence of bony tunnel formation in the middle meningeal groove, actual findings can be different from the accepted nomenclature. If a tunnel exists, the MMA is easily damaged upon cracking of the lesser wing during bone flap elevation. Recognition of this anatomy may render pterional craniotomy safer.


Assuntos
Craniotomia/métodos , Artérias Meníngeas/anatomia & histologia , Crânio/anatomia & histologia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Neurocirúrgicos/métodos , Osteogênese
4.
Minim Invasive Neurosurg ; 51(2): 119-23, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18401827

RESUMO

OBJECTIVE: In the dissection of the superior orbital rim, the supraorbital foramen must be released to preserve the supraorbital nerve. The aim of this study was to clarify the spatial dimensions of a high-positioned foramina to allow for the safe performance of this maneuver. METHODS: We examined 90 orbital sides. In the detected foramina we measured the distance between the superior orbital rim and the inferior margin of the foramen (height), and between the rim and the anterior margin of the opening of the foramen in the orbital roof (depth). To evaluate the inclination of the canal, we calculated the height:depth ratios. Foramina with a height exceeding 2.0 mm were defined as high-positioned and measurements between low- and high-positioned foramina were compared. RESULTS: We were able to find 37 foramina in 32 orbital sides; 25 (67.6%) were low-positioned and their height ranged from 0.5-1.9 mm (mean: 1.16 mm); 12 (32.4%) were high-positioned with a height ranged from 2.0-11.9 mm (mean: 4.0 mm). The depth in low- and high-positioned foramina ranged from 0.5-3.2 mm (mean: 1.44 mm) and 0.7-6.5 mm (mean: 2.13 mm), respectively. The height:depth ratio was greater in high-positioned foramina, ranging from 1.03-3.38 (mean: 2.19), than in low-positioned foramina where it ranged from 0.4-2.2 (mean: 0.98). CONCLUSION: The height:depth ratio in high-positioned foramina, an approximate mean value of 2, and the absence of a value less than 1, was considered to indicate a steep canal inclination. To avoid postoperative forehead numbness, anatomic information regarding the course of the bony canal must be considered.


Assuntos
Craniofaringioma/cirurgia , Craniotomia/normas , Osso Frontal/anatomia & histologia , Nervo Oftálmico/anatomia & histologia , Órbita/anatomia & histologia , Craniotomia/efeitos adversos , Dissecação/métodos , Testa/inervação , Humanos , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/normas , Nervo Oftálmico/cirurgia , Órbita/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Couro Cabeludo/inervação , Pele/inervação , Distúrbios Somatossensoriais/etiologia , Distúrbios Somatossensoriais/prevenção & controle
5.
Minim Invasive Neurosurg ; 51(2): 124-5, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18401828

RESUMO

Sterility and utility are essential in surgical draping. For craniotomy, we modified the course of the irrigation hose to maintain a free foot space for the surgeon by connection with a suction bottle placed beside the patient's body through a slit made in the linen. This minor modification provides convenience to the surgeon during operations.


Assuntos
Craniotomia/métodos , Contaminação de Equipamentos/prevenção & controle , Equipamentos Cirúrgicos/normas , Irrigação Terapêutica/métodos , Craniotomia/instrumentação , Drenagem/instrumentação , Drenagem/métodos , Desenho de Equipamento/métodos , Ergonomia/métodos , Pé/fisiologia , Humanos , Neurocirurgia/instrumentação , Salas Cirúrgicas/normas , Sucção/instrumentação , Sucção/métodos , Instrumentos Cirúrgicos/normas , Infecção da Ferida Cirúrgica/prevenção & controle , Irrigação Terapêutica/instrumentação
6.
Interv Neuroradiol ; 14(2): 137-41, 2008 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-20557754

RESUMO

SUMMARY: Angiosarcoma is a rare, highly malignant tumor with a poor clinical outcome. From January 2004 to September 2005, we advocated transarterial chemotherapy using a port system for four patients with angiosarcomas of the face and scalp. A heparin coated ANTHRON P-Ucatheter was introduced into the feeding artery. The proximal part of the P-U catheter was connected to the port system and buried in subcutaneous tissue. The amount of chemotherapeutic drug applied using the port system was almost the same as the conventional intravenous dose. Paclitaxel was the standard agent, at 50-100 mg/diluted in 15-30 ml of physiological saline fluid slowly injected over 0.5-1 hour. For immunotherapy where appropriate, r-IL2 was mainly used at a dose of 70.000U/ diluted in 5 ml of physiological saline fluid injected into the port system over 30 seconds. This was continued for two to three weeks (five days/week) until recognition of a disappearance of the tumor. Macroscopic size reduction of the tumor was achieved in three out of the four cases. One case could not be evaluated because of eruptions induced by immunotherapy. Unfortunately two patients died after placement of port system, but the other two are still alive and are enjoying useful lives. Transarterial infusion chemotherapy using such a port system may be particularly effective for angiosarcoma in the early stages because small lesions with limited invasion mean a small territory of blood supply to be covered, and useful life was possible because the port system embedded in subcutaneous tissue allows treatment in an out-patient clinic.

7.
Minim Invasive Neurosurg ; 50(1): 60-1, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17546547

RESUMO

The authors present a method for applying sterile surgical tape to neurosurgical instruments (suckers and/or ultrasonic surgical implements) as depth gauges in brain tumor surgery. This simple and inexpensive modification is helpful in the achievement of gross anatomic orientation in situations where it is difficult to find anatomic landmarks, e.g., with initial detachment of large meningiomas from the dura in the deep region.


Assuntos
Neoplasias Encefálicas/cirurgia , Neurocirurgia/instrumentação , Fita Cirúrgica , Humanos , Instrumentos Cirúrgicos
8.
Acta Neurochir (Wien) ; 149(6): 601-4, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17460815

RESUMO

A 60-year-old woman presented with a subcutaneous mass on her scalp. Computed tomography (CT) showed a homogeneously enhanced mass of the parietal bone with both intra- and extra-calvarial extension and having destroyed the right parietal bone. The mass was hypointense on the T1-weighted magnetic resonance image, slightly hyperintense on the T2-weighted image and homogenously enhanced with Gd-DTPA. Bone scintigraphy showed prominent accumulation of radioisotopes in the scalp lesion. The tumour was removed, including the involved bone and dura mater. Histologic diagnosis was non-Hodgkin's B-cell lymphoma, and tumour cells had infiltrated into the dura mater. The patient was treated with radiotherapy and chemotherapy. She returned to ordinary daily life and has been well without recurrence for 3 years. Although primary malignant lymphoma of the cranial vault is rare, it should be considered in the differential diagnosis when a mass is encountered in the cranial vault. We have found only fourteen such cases in the literature, and we review these cases.


Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico , Imageamento por Ressonância Magnética , Osso Parietal , Neoplasias Cranianas/diagnóstico , Tomografia Computadorizada por Raios X , Quimioterapia Adjuvante , Terapia Combinada , Meios de Contraste/administração & dosagem , Feminino , Seguimentos , Gadolínio DTPA , Humanos , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/cirurgia , Pessoa de Meia-Idade , Osso Parietal/patologia , Cintilografia , Radioterapia Adjuvante , Neoplasias Cranianas/patologia , Neoplasias Cranianas/cirurgia
9.
Clin Neuropathol ; 26(1): 17-20, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17290932

RESUMO

We report a usual case of papillary meningioma arising from tentorium cerebelli occurring in a 13-year-old boy. This patient presented a 3-month history of a mildly poor coordination of the left side of his body. Computed tomography showed a homogenous enhanced mass lesion in the left posterior fossa. At surgery, gross total resection of the tumor was accomplished. Upon microscopic examination, some tumor cells were arranged in the papillary pattern and a resulting diagnosis of papillary meningioma was made. Electron microscopic studies showed typical meningioma features such as interdigitations and desmosomes, which were, however, detectable in only few tumor cells. Cytological and ultrastructural features of pediatric papillary meningioma and of high-grade meningioma in general are sparse. Since papillary meningioma rarely presents in children, we report this case and review the literature.


Assuntos
Neoplasias Cerebelares/patologia , Meningioma/patologia , Adolescente , Neoplasias Cerebelares/cirurgia , Humanos , Masculino , Meningioma/cirurgia
10.
Acta Neurochir (Wien) ; 148(11): 1197-200; discussion 1200, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17039305

RESUMO

A 29-year-old man presented with diplopia, dysarthria, anisocoria, oculomotor nerve paralysis, abducens nerve paralysis, right facial palsy, and spastic hemiparetic gait. Magnetic resonance imaging (MRI) showed a homogenously enhanced mass in the midbrain. MRI-guided stereotactic biopsy was performed, and the histologic diagnosis was pure germinoma. The tumor disappeared after chemotherapy and radiotherapy. Germinoma should be included in the differential diagnosis of midbrain lesions in young adults. MRI-guided stereotactic biopsy provided a helpful diagnostic clue in a patient with a midbrain lesion.


Assuntos
Neoplasias do Tronco Encefálico/diagnóstico , Neoplasias do Tronco Encefálico/terapia , Germinoma/diagnóstico , Germinoma/terapia , Mesencéfalo/patologia , Adulto , Anisocoria/etiologia , Anisocoria/patologia , Anisocoria/fisiopatologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Diplopia/etiologia , Diplopia/patologia , Diplopia/fisiopatologia , Tratamento Farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Mesencéfalo/fisiopatologia , Neuronavegação , Doenças do Nervo Oculomotor/etiologia , Doenças do Nervo Oculomotor/patologia , Doenças do Nervo Oculomotor/fisiopatologia , Radioterapia , Resultado do Tratamento
11.
Clin Neuropathol ; 25(2): 81-5, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16550741

RESUMO

Spinal atypical teratoid/rhabdoid tumor (AT/RT) is extremely rare. We report this rare case and review the literature of spinal AT/RT. A 10-month-old girl presented with rapidly progressive paraplegia. Magnetic resonance images revealed an intramedullary tumor occupying the entire spinal canal below Th10. An urgent operation, consisting of decompression by laminectomy and biopsy, was performed. Histologically, the tumor specimen had many rhabdoid cells with prominent nuclei and eosinophilic cytoplasmic inclusion. It showed mitosis and necrosis. The tumor cells were immunoreactive for vimentin, desmin, smooth muscle actin, neuron-specific enolase, neurofilament, epithelial membrane antigen, and CAM5.2. Despite chemotherapy and radiotherapy, she died 3 months after admission. The present case is only the third detailed report of spinal AT/RT. Spinal AT/RT carries a poor prognosis, and therefore should be distinguished from other embryonal tumor.


Assuntos
Tumor Rabdoide/patologia , Neoplasias da Medula Espinal/patologia , Teratoma/patologia , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Imuno-Histoquímica , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Microscopia Eletrônica de Transmissão , Tumores Neuroectodérmicos Primitivos/patologia , Paraplegia/etiologia , Tumor Rabdoide/metabolismo , Tumor Rabdoide/terapia , Neoplasias da Medula Espinal/metabolismo , Neoplasias da Medula Espinal/terapia , Teratoma/metabolismo , Teratoma/terapia , Vértebras Torácicas
12.
Minim Invasive Neurosurg ; 49(1): 58-9, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16547885

RESUMO

The naming task, one of the most important tasks for screening essential language function, is widely used in awake surgery. We employed personal digital assistants (PDA) for the display of objects in three patients performing the naming task during awake surgery for gliomas adjacent to the language area in the left hemisphere. The compact, light-weight, self-illuminated instrument can easily be held close to the patient's face. None had difficulty seeing the screen despite the presence of the surgical drape around the face. The examiner could easily change the displayed objects with a click. However, the PDA screen is too small for use in auditory comprehension tasks such as the Token Test.


Assuntos
Mapeamento Encefálico/instrumentação , Neoplasias Encefálicas/cirurgia , Córtex Cerebral/fisiologia , Computadores de Mão , Glioma/cirurgia , Testes de Linguagem , Humanos
13.
Clin Neuropathol ; 25(1): 25-8, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16465771

RESUMO

OBJECTIVE: The histogenesis of craniopharyngioma is not fully understood. We encountered a ciliated craniopharyngioma, the details of which may shed light on the histogeny of craniopharyngioma in general. PATIENT: A 74-year-old man presented with visual disturbance. Computed tomography showed an intra-suprasellar cyst including a solid tumor. Transsphenoidal surgery was performed. During surgery, the cyst was found to contain mucoid milky-white fluid and a solid tumor 1 cm in diameter. Histologically, the tumor was shown to be a papillary type craniopharyngioma with foci of ciliated columnar epithelial cells. Ciliated craniopharyngioma was diagnosed. CONCLUSION: Our findings in this case together with findings in other reported cases suggest that the basal cells of Rathke cleft cyst transform to papillary type craniopharyngioma after squamous metaplasia, explaining the presence of the cilia and goblet cells.


Assuntos
Cistos do Sistema Nervoso Central/patologia , Craniofaringioma/patologia , Neoplasias Hipofisárias/patologia , Idoso , Cistos do Sistema Nervoso Central/cirurgia , Craniofaringioma/cirurgia , Humanos , Masculino , Neoplasias Hipofisárias/cirurgia , Tomografia Computadorizada por Raios X
14.
Clin Neuropathol ; 24(1): 8-12, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15696778

RESUMO

Invasive meningioma shows benign histological features (WHO grade 1) and the brain expansion at the tumor-brain interface, and recurs more frequently than common meningiomas. To determine the mechanism of brain expansion, we studied the relationship between invasive meningioma and cell adhesion molecules. Immunostaining for E-cadherin (E-CH), N-cadherin (N-CH), beta-catenin, and Ki-67 was performed in 103 meningiomas that consisted of 61 meningothelial meningiomas, 25 fibrous meningiomas, 12 invasive meningiomas and 5 anaplastic meningiomas. All tumors were negative for N-CH. All the 61 meningothelial meningiomas, 10 of 12 invasive meningiomas, and 3 of 5 anaplastic meningiomas were positive for both E-CH and beta-catenin, while these were both negative in all of the fibrous meningiomas. In invasive meningiomas, the expansive part of the tumor showed a lower rate (4/12 tumors) of E-CH and beta-catenin positivity, while the central part showed a higher rate (10/12 tumors). The Ki-67 labeling index was higher in invasive and anaplastic meningiomas than in meningothelial meningiomas. These results suggest that a reduction in cell adhesion molecules and increased proliferative activity may be related, which may lead to a better understanding of the mechanism of meningioma expansion in the future.


Assuntos
Caderinas/metabolismo , Proteínas do Citoesqueleto/metabolismo , Neoplasias Meníngeas/metabolismo , Neoplasias Meníngeas/patologia , Meningioma/metabolismo , Meningioma/patologia , Transativadores/metabolismo , Humanos , Técnicas Imunológicas , Antígeno Ki-67/metabolismo , Invasividade Neoplásica , Coloração e Rotulagem , beta Catenina
15.
Acta Neurochir (Wien) ; 145(8): 663-6; discussion 666, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-14520545

RESUMO

Medulloblastoma may can be difficult to distinguish from atypical teratoid/rhabdoid tumor (AT/RT), since they resemble each other histologically. We re-examined whether AT/RT was included among cases who had been diagnosed as medulloblastoma. All of fifteen medulloblastomas (10 males and 5 females) diagnosed at the Kitasato University Hospital were collected and stained immunohistochemically. Two cases originally diagnosed as medulloblastoma were reclassified as AT/RT based on histological re-examination including immunohistochemical studies. While these two cases of AT/RT were found during infancy, only one medulloblastoma was found in infancy.Histologically, small rhabdoid cells and large, pale, bland cells were common but typical rhabdoid cells were not seen in the two AT/RTs. Gland-like structures were also seen. The tumor cells in AT/RT, but not those in medulloblastoma, were immunoreactive for vimentin, epithelial membrane antigen and smooth muscle actin. In conclusion, if a diagnosis of medulloblastoma is made histologically, it should be confirmed immunohistologically, since it is difficult to distinguish AT/RT from medulloblastoma. When appropriate treatment was specifically targeted at AT/RT it may improve the outcome.


Assuntos
Neoplasias Cerebelares/patologia , Erros de Diagnóstico , Meduloblastoma/patologia , Tumor Rabdoide/patologia , Teratoma/patologia , Adolescente , Adulto , Neoplasias Cerebelares/imunologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Lactente , Masculino , Meduloblastoma/imunologia , Estudos Retrospectivos , Tumor Rabdoide/imunologia , Teratoma/imunologia
16.
Clin Neuropathol ; 21(6): 248-51, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12489672

RESUMO

The patient was a 6 year-old girl with a progressive loss of visual acuity. Magnetic resonance imaging showed a suprasellar mass lesion with enhanced gadolinium which was resected. Histopathological study showed a remarkable granulomatous reaction, but a diagnosis was difficult. However, immunohistochemical study showed a few cells that were positive for placental alkaline phosphatase and it was diagnosed as germinoma. Intracranial germinoma with a remarkable granulomatous reaction is rare. However, when germinoma is suspected clinically, an immunohistochemical study is able to identify germinoma even if granulomatous disease is diagnosed histopathologically.


Assuntos
Neoplasias Encefálicas/diagnóstico , Germinoma/diagnóstico , Granuloma/diagnóstico , Fosfatase Alcalina , Antineoplásicos/uso terapêutico , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Criança , Cisplatino/uso terapêutico , Diagnóstico Diferencial , Etoposídeo/uso terapêutico , Feminino , Proteínas Ligadas por GPI , Germinoma/metabolismo , Germinoma/patologia , Germinoma/radioterapia , Germinoma/cirurgia , Granuloma/metabolismo , Granuloma/patologia , Granuloma/radioterapia , Granuloma/cirurgia , Humanos , Imuno-Histoquímica , Isoenzimas/metabolismo , Imageamento por Ressonância Magnética
17.
Acta Neurochir (Wien) ; 144(11): 1151-4; discussion 1154-5, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12434171

RESUMO

OBJECTIVE: Pure germinomas have a good prognosis compared to those with syncytiotrophoblastic giant cells (STGCs), which show elevated human chorionic gonadotropin or human chorionic gonadotropin-beta (hCG/hCG-beta) levels and relapse frequently. However, the long-term outcome of patients with germinoma and detectable hCG/hCG-beta in cerebrospinal fluid (CSF) but not in serum is unclear. MATERIALS AND METHODS: The outcome of patients with pure germinomas (no increase in hCG/hCG-beta in serum or CSF, 13 cases; group A), germinomas with STGC (increased hCG/hCG-beta in serum, 13 cases; group B) and germinomas with increased hCG/hCG-beta only in CSF (6 cases; group C) was analyzed. RESULTS: All three groups received similar radiotherapy. Groups A and C each showed a 10-year survival rate of 100%, while this was only 69.2% in group B. The 10-year relapse-free survival rates were 92.3%, 69.2% and 83.3% (groups A, B and C, respectively). Groups A and C each had one case of tumor relapse, but there was no recurrence simply by the application of radiotherapy. On the other hand, in group B, tumor relapse was seen in 4/13 (30.8%) cases. Three of them showed relapse within the region of the initial radiation exposure and died despite all available treatment. CONCLUSION: Patients with an increased hCG/hCG-beta level in CSF may be considered to be similar to pure germinomas and should be treated and followed-up carefully.


Assuntos
Neoplasias Encefálicas/líquido cefalorraquidiano , Gonadotropina Coriônica Humana Subunidade beta/líquido cefalorraquidiano , Gonadotropina Coriônica/líquido cefalorraquidiano , Germinoma/líquido cefalorraquidiano , Adolescente , Adulto , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/cirurgia , Criança , Feminino , Seguimentos , Germinoma/mortalidade , Germinoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/líquido cefalorraquidiano , Recidiva Local de Neoplasia/mortalidade , Taxa de Sobrevida
19.
Acta Neurochir (Wien) ; 144(1): 97-101, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11807652

RESUMO

BACKGROUND: A rare case of a left temporal arteriovenous malformation (AVM) with bleeding 10 days after removal of another hemorrhagic AVM in the frontal lobe is reported. METHOD: A 47-year-old man had an attack of headache and vomiting and was admitted to our hospital. On admission, a CT scan showed subcortical hemorrhage in the left frontal lobe. Left carotid angiography revealed four AVMs and a vertebro-basilar angiogram demonstrated a vascular malformation. FINDINGS: First, a hemorrhagic AVM was removed with a hematoma. Following the operation, left carotid angiograms continued to show, AVMs, particularly a temporal AVM with increased blood flow, and after 10 days this hemorrhaged. This was surgically resected and the remaining small AVMs were treated by stereotactic radiosurgery. INTERPRETATION: The patient had a high risk of hemorrhage. Adding hemodynamic stress to this situation, hemorrhage would have been expected to occur at an early time after the initial intervention for hemorrhagic AVM. Considering the risk of hemorrhage, other AVMs should undergo surgery as soon as possible after resection of hemorrhagic AVM.


Assuntos
Hemorragia Cerebral/etiologia , Lobo Frontal/patologia , Malformações Arteriovenosas Intracranianas/patologia , Angiografia Cerebral , Hemorragia Cerebral/patologia , Hemodinâmica , Humanos , Malformações Arteriovenosas Intracranianas/complicações , Malformações Arteriovenosas Intracranianas/cirurgia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Lobo Temporal/patologia
20.
Ann Nucl Med ; 15(2): 157-60, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11448076

RESUMO

A 7-year-old boy developed mutism after surgery for cerebellar medulloblastoma. Postoperative magnetic resonance imaging (MRI) showed atrophy of the cerebellar vermis and both cerebellar hemispheres, predominantly on the right side. Single photon emission computed tomography (SPECT) with technetium-99m-ethyl cysteinate dimer (Tc-99m ECD) revealed decreased cerebral blood flow (CBF) in the bilateral thalami, bilateral medial frontal lobes, and left temporal lobe in addition to the cerebellar vermis and both cerebellar hemispheres when mutism was manifest, indicating the existence of bilateral crossed cerebello-cerebral diaschisis (BCCCD). Circulatory disturbance in both cerebellar hemispheres secondary to tumor resection probably caused BCCCD in both cerebral hemispheres, predominantly in the left, via the dentatothalamocortical pathway (DTCP). With recovery of his mutism, CBF increased in the right thalamus, bilateral medial frontal lobes and left temporal lobe. Thus BCCCD was improved, with only a slight decrease in CBF still persisting in the left thalamus. The mechanism of mutism may have involved damage to the cerebellar vermis (the site of incision at operation), the left dentate nucleus (heavily infiltrated by the tumor) and the right dentate nucleus of the cerebellum (affected by circulatory disturbance secondary to acute postoperative edema). The SPECT findings suggested that mutism was associated with BCCCD-induced cerebral circulatory and metabolic hypofunction in the supplementary motor area mediated via the DTCP.


Assuntos
Neoplasias Cerebelares/cirurgia , Cerebelo/irrigação sanguínea , Cerebelo/lesões , Circulação Cerebrovascular , Cisteína/análogos & derivados , Meduloblastoma/cirurgia , Mutismo/diagnóstico por imagem , Mutismo/etiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Criança , Humanos , Masculino , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único
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