1/577. Transient paralytic attacks of obscure nature: the question of non-convulsive seizure paralysis.Eleven patients with transient paralytic attacks of obscure nature are described. paralysis could involve face or leg alone, face and hand, or face, arm and leg. The duration varied from two minutes to one day. Four patients had brain tumors, six probably had brain infarcts, and one a degenerative process. The differential diagnosis included TIAs, migraine accompaniments, and seizures. In the absence of good evidence for the first two, the cases are discussed from the standpoint of possibly representing nonconvulsive seizure paralysis (ictal paralysis, inhibitory seizure paralysis or somatic inhibitory seizure). Because of the difficulty in defining seizures as well as TIAs and migraine in their atypical variations, a firm conclusion concerning the mechanisms of the spells was not attained. Two cases of the hypertensive amaurosis-seizure syndrome have been added as further examples of ictal deficits.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/577. Multiple postoperative intracerebral haematomas remote from the site of craniotomy.A postoperative haemorrhage is a common and serious complication of a neurosurgical procedure. It usually occurs at the site of the surgery, but on occasion a postoperative haematoma is found at a distance from the previous craniotomy. Multiple postoperative haemorrhages are extremely rare. We report the case of a 63-year-old woman, operated on for the removal of a supratentorial astrocytoma, who developed in the early post-operative period multiple bilateral intracerebral haematomas without involvement of the surgical bed.- - - - - - - - - - ranking = 1.4796991052294keywords = haemorrhage (Clic here for more details about this article) |
3/577. Transient peduncular hallucinations secondary to brain stem compression by a cerebellar pilocytic astrocytoma.Almost all peduncular hallucinations have been described in patients with intrinsic lesions of the midbrain. An, as yet, unreported case of peduncular hallucinosis caused by posterior compression of the midbrain by a cerebellar pilocytic astrocytoma is described. The hallucinations and associated symptoms only ceased after removal of the tumour.- - - - - - - - - - ranking = 10.28168893468keywords = brain stem, brain, midbrain, stem (Clic here for more details about this article) |
4/577. Invasive giant cell astrocytoma of the retina in a patient with tuberous sclerosis.OBJECTIVE: To report an unusual case of giant cell astrocytoma of the retina. DESIGN: Case report. INTERVENTION: A 10-month-old girl with tuberous sclerosis was found to have bilateral astrocytic hamartomas, the right eye being prominently involved by elevated and pedunculated lesions. At 7 years of age, she had posterior subcapsular cataract, retinal detachment, and subretinal exudation develop in the right eye. At 12 years of age, her blind, painful right eye had to be enucleated because of neovascular glaucoma and a spontaneous scleral perforation. RESULTS: Histopathologic examination showed that the entire vitreous cavity was filled with a mixture of tumor, granulation tissue, and necrotic debris. Part of the tumor was composed of spindle-shaped glial cells. The remainder was composed of large gemistocytic cells that contained large atypical nuclei and copious amounts of cytoplasm, which was intensely eosinophilic in some areas. The tumor contained foci of necrosis and rare mitotic figures. It had infiltrated the parenchyma of the retrolaminar nerve and extended to the surgical margin. Areas of unequivocal choroidal invasion were also identified. The tumor cells were intensely immunoreactive for neuron-specific enolase and S-100 protein. In contrast, glial fibrillary acidic protein was only minimally positive. CONCLUSIONS: The histologic and immunohistochemical features of this retinal tumor resemble those of subependymal giant cell astrocytoma, a characteristic lesion in tuberous sclerosis. Although this unusual giant cell astrocytoma of the retina had atypical histopathologic features and local aggressive behavior, the systemic prognosis was excellent.- - - - - - - - - - ranking = 0.026943636284852keywords = stem (Clic here for more details about this article) |
5/577. Neuro-ophthalmologic manifestations of Maffucci's syndrome and Ollier's disease.patients with Ollier's disease (multiple skeletal enchondromas) and Maffucci's syndrome (multiple enchondromas associated with subcutaneous hemangiomas) may develop skull base chondrosarcomas or low-grade astrocytomas as a delayed consequence of these disorders. We report three patients with Ollier's disease and Maffucci's syndrome who had diplopia as the initial manifestation of intracranial tumors. Since patients with Maffucci's syndrome and Ollier's disease are at risk for the delayed development of brain and systemic neoplasms, neuroophthalmologists must be aware of the need for long-term surveillance in patients affected by these conditions.- - - - - - - - - - ranking = 0.52694363628485keywords = brain, stem (Clic here for more details about this article) |
6/577. Interventional magnetic resonance imaging guided aspiration and biopsy of a cystic midbrain tumor.Interventional magnetic resonance imaging defines the intraoperative application of magnetic resonance imaging technology, permitting the surgeon to work in an open magnetic field. The application of this technology to pediatric neurosurgery allows precise intraoperative localization of pathology, real-time assessment of the anatomical consequences of surgical and anesthetic interventions, accountability of brain shifts, confirmation of the exact site of biopsy or completeness of lesion removal, and immediate identification of some intraoperative and early postoperative complications. We present the case of a young boy with a cystic left midbrain tumor who underwent interventional magnetic resonance imaging guided aspiration and biopsy to illustrate the surgical advantages of this technology.- - - - - - - - - - ranking = 4.378892984872keywords = brain, midbrain (Clic here for more details about this article) |
7/577. Unexpected death in persons with symptomatic epilepsy due to glial brain tumors: a report of two cases and review of the literature.Two cases of unexpected death in persons with epileptic seizures due to a brain tumor are presented which encompassed an astrocytoma WHO grade II and an anaplastic astrocytoma WHO grade III. A 35-year-old man was found somnolent and disoriented at home. A computed tomography (CT) scan revealed a tumor of the right frontal lobe suggestive for an oligodendroglioma. During an angiographic examination the patient experienced an epileptic seizure. Some weeks later, the man was found dead in front of his house with a fresh bite mark of the tongue. Neuropathological examination revealed an astrocytoma WHO grade II of the right frontal lobe. A 47-year-old man plunged into a swimming-pool and was found submerged some minutes later. After resuscitation he survived comatose for 8 days but finally died due to severe hypoxic brain damage. He had been operated on a brain tumor of the temporal lobe 1 year before the accident. Neuropathological examination revealed residual tumor tissue at the operation site corresponding to an anaplastic astrocytoma WHO grade III. Although rare, death in persons with epileptic seizures due to brain tumors is an important mechanism of death encountered by the forensic pathologist.- - - - - - - - - - ranking = 4keywords = brain (Clic here for more details about this article) |
8/577. Electroconvulsive treatment of a bipolar adolescent postcraniotomy for brain stem astrocytoma.This is the first reported use of electroconvulsive treatment (ECT) in an adolescent with bipolar mania who had been treated with craniectomy for an intracranial neoplasm. The reported case is of a 16-year-old girl with a history of brain stem glioma (pontomesencephalic astrocytoma) diagnosed at 13 years of age. She presented in a psychiatric emergency room with suicidal ideation, depressed mood, irritability, olfactory hallucinations, early insomnia, grandiosity, and guilt. Her symptoms failed to respond to a trial of an antidepressant, mood stabilizer alone, and mood stabilizer in conjunction with a neuroleptic. The decision to use ECT was based on suicidal ideation, extreme disinhibition, and danger to self and others. Significant improvement in mood and remission in psychosis were noted after the eighth treatment. Comparison of 2-week pre-ECT and 3-month post-ECT cognitive testing revealed no change in IQ. This report highlights rapid response and the ability to tolerate ECT in an adolescent diagnosed with bipolar disorder, who had also been treated with radiation and craniotomy.- - - - - - - - - - ranking = 10.912664675914keywords = brain stem, brain, stem (Clic here for more details about this article) |
9/577. Mutations of the adenomatous polyposis coli and p53 genes in a child with Turcot's syndrome.Turcot's syndrome is a rare heritable complex that is characterized by an association between a primary neuroepithelial tumor of the central nervous system and multiple colonic polyps. The aim of this study was to analyze genetic alterations in a case of Turcot's syndrome in a 10.5-year-old boy in whom a colorectal tumor developed 3.5 years following astrocytoma. An APC germline non-sense mutation at codon 1284 leading to a truncated protein was identified, as was a somatic p53 mutation in the colorectal carcinoma in exon 7, codon 244. The latter was not identified in the primary astrocytoma. However, immunohistochemistry revealed high p53 protein expression in both tumors, suggesting an additional p53 mutation in the primary astrocytic tumor. The diverse p53 mutations observed in this unique syndrome in two different sites and stages of the disease may shed light on the multistep progression of the malignant events.- - - - - - - - - - ranking = 0.026943636284852keywords = stem (Clic here for more details about this article) |
10/577. Squash cytology of pleomorphic xanthoastrocytoma mimicking glioblastoma. A case report.BACKGROUND: Pleomorphic xanthoastrocytoma (PXA) is an uncommon, superficially located and well-circumscribed brain tumor that originates in astrocytic cells. Despite the fact that the tumor cells are pleomorphic, with bizarre nuclei, the clinical course is favorable. Cytologic and histologic differentiation from other high grade gliomas is necessary to determine adequate therapy during surgery. Cytomorphologic features of this tumor have been described only rarely. CASE: A 22-year-old male had complained of visual disturbance for about a year. Radiologic imaging revealed a well-circumscribed mass with cyst formation in the left temporal area. Squash specimens from fresh tissues were highly cellular. Tumor cells were markedly pleomorphic, with long and coarse cytoplasmic processes showing a fibrillary astrocytic appearance. Pleomorphic cells varied in shape from round to elongated and had large, multilobed, hyperchromatic nuclei but few nuclear mitoses. Sometimes eosinophilic granular bodies were also observed. blood vessels were found frequently in tumor cell clusters, but their endothelium was not swollen. In the background, considerable leukocytic infiltration, but no cellular debris, was observed. With immunohistochemical studies, most of the tumor cells were positive for glial fibrillary acidic protein and S-100 protein. Some of the mononuclear giant cells were positive for synaptophysin. CONCLUSION: Squash preparations showed the peculiar cytologic features of PXA. Together with the peculiar radiologic findings, the cytologic results make it possible to render a diagnosis of PXA.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
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