1/234. Symptomatic vasospasm after resection of a suprasellar pilocytic astrocytoma: case report and possible pathogenesis.BACKGROUND: Cerebral vasospasm from pathology other than subarachnoid hemorrhage is uncommon. A case of severe vasospasm after resection of a suprasellar pilocytic astrocytoma is reported. methods: A 45-year-old male presented with headache, left facial numbness, bilateral visual loss, and ataxia. Evaluation revealed a large suprasellar tumor, which was resected. Pathologic examination showed pilocytic astrocytoma. The patient developed hemiparesis and aphasia on the fifth postoperative day. Vascular spasm was documented on angiography and by transcranial Doppler. RESULTS: Intraarterial papaverine resulted in moderate angiographic improvement. Attempts to open middle cerebral artery branches with angioplasty were unsuccessful. The patient subsequently developed a left middle cerebral artery infarct. CONCLUSIONS: To our knowledge, this is the first description of vasospasm after resection of an astrocytoma. Possible mechanisms contributing to this unusual complication after resection of tumors are discussed.- - - - - - - - - - ranking = 1keywords = suprasellar (Clic here for more details about this article) |
2/234. 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 = 0.055892976117444keywords = cyst (Clic here for more details about this article) |
3/234. 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 = 0.31420622682143keywords = central nervous system, nervous system (Clic here for more details about this article) |
4/234. 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 = 0.011178595223489keywords = cyst (Clic here for more details about this article) |
5/234. Secondary supratentorial anaplastic astrocytoma following treatment of medulloblastoma.The development of secondary tumours is a rare but well known late effect of radiation therapy of lesions in the central nervous system. Most radiation-induced tumours are of mesenchymal origin, but on rare occasions gliomas can occur. We describe a patient in whom a supratentorial anaplastic astrocytoma developed 15 years after surgery and radiotherapy for a childhood posterior fossa medulloblastoma. A concise review of the pertinent literature is given.- - - - - - - - - - ranking = 0.31420622682143keywords = central nervous system, nervous system (Clic here for more details about this article) |
6/234. Coexistence of intracranial arteriovenous malformation with Turcot's syndrome: a case report.Turcot's syndrome is a combination of multiple adenomatous gastrointestinal polyps and neuroepithelial tumors of the central nervous system (CNS). A 16-year-old man presented with Turcot's syndrome consisting of nonfamilial colorectal polyposis and multiple fibrillary astrocytomas accompanied by ruptured intracranial arteriovenous malformation (AVM) manifesting as generalized epileptic activity. Multiple CNS tumors are extremely unusual in Turcot's syndrome. This is the first description of Turcot's syndrome associated with an intracranial AVM. This case may correspond to a new phenotypic variant of colonic polyposis syndrome.- - - - - - - - - - ranking = 0.31420622682143keywords = central nervous system, nervous system (Clic here for more details about this article) |
7/234. Peduncular hallucinosis: an unusual sequel to surgical intervention in the suprasellar region.Peduncular hallucinations are formed visual images often associated with sleep disturbance, and are caused by lesions in the midbrain, pons and diencephalon. In the present study, we report two patients who developed peduncular hallucinations following surgery in the suprasellar region. In one of these, the peduncular hallucinations were a sequel to endoscopic third ventriculostomy, while in the other, they were due to diencephalon and mid-brain compression by a postoperative clot following excision of a hypothalamic astrocytoma.- - - - - - - - - - ranking = 0.83333333333333keywords = suprasellar (Clic here for more details about this article) |
8/234. Successful use of intracavitary bleomycin for low-grade astrocytoma tumor cyst.We report successful use of bleomycin in a low-grade astrocytoma tumor cyst of the tectal plate. A 6-year-old male underwent subtotal resection of a low-grade astrocytoma of the tectal plate followed by chemotherapy and proton beam radiation at age 2 and a half. Despite resolution of the solid portion of the tumor, serial MRI showed enlargement of a bilobar tumor cyst 3 years after the original diagnosis. The patient developed progressive ataxia, short-term memory loss and dysconjugate gaze. Following stereotactic placement of an Ommaya reservoir into the cyst, Isovue contrast and CT scan were used to confirm the integrity of the cyst. Five consecutive daily doses of 3.0 mg of bleomycin were instilled into the cyst after removal of cyst fluid. The therapy was well tolerated in the outpatient setting, and the clinical findings resolved. Subsequent CT and MRI at 4 months and 2 years after bleomycin confirmed no recurrence of the tumor or cyst.- - - - - - - - - - ranking = 0.12296454745838keywords = cyst (Clic here for more details about this article) |
9/234. Malignant transformation of a dysembryoplastic neuroepithelial tumor. Case report.A 29-year-old man presented in 1984 with a recent onset of partial seizures marked by speech arrest. electroencephalography identified a left frontotemporal dysrhythmia. Computerized tomography (CT) scanning revealed a superficial hypodense nonenhancing lesion in the midleft frontal convexity, with some remodeling of the overlying skull. The patient was transferred to the london health Sciences Centre for subtotal resection of what was diagnosed as a "fibrillary astrocytoma (microcystic)." He received no chemotherapy or radiation therapy and remained well for 11 years. The patient presented again in late 1995 with progressive seizure activity. Both CT and magnetic resonance imaging demonstrated a recurrent enhancing partly cystic lesion. A Grade IV astrocytoma was resected, and within the malignant tumor was a superficial area reminiscent of a dysembryoplastic neuroepithelial tumor (DNT). Data on the lesion that had been resected in 1984 were reviewed, and in retrospect the lesion was identified as a DNT of the complex form. It was bordered by cortical dysplasia and contained glial nodules, in addition to the specific glioneuronal element. The glial nodules were significant for moderate pleomorphism and rare mitotic figures. The Ki67 labeling index averaged 0.3% in the glial nodules and up to 4% focally. Cells were rarely Ki67 positive within the glioneuronal component. This case is the first documented example of malignant transformation of a DNT. It serves as a warning of the potential for malignant transformation in this entity, which has been traditionally accepted as benign. This warning may be especially warranted when confronted with complex forms of DNT. The completeness of resection in the benign state is of paramount importance.- - - - - - - - - - ranking = 0.022357190446978keywords = cyst (Clic here for more details about this article) |
10/234. moyamoya disease associated with a brain stem glioma.An 8-year-old boy was found to have primary moyamoya disease associated with a brain stem glioma. For over 3 years the child had experienced transient ischemic attacks induced by hyperventilation. One month before referral to our hospital he had presented with progressive left facial nerve palsy. magnetic resonance imaging showed a cystic mass in the lower pons. angiography revealed severe bilateral stenosis of the internal carotid arteries and prominent moyamoya vessels in the basal ganglia. Partial resection of the tumor yielded a histological diagnosis of pilocytic astrocytoma. Local radiation therapy reduced the size of the tumor. Anastomosis of the superficial temporal arteries and middle cerebral arteries on both sides was then performed. After direct bypass surgery, the patient remained in a good condition for a 5-year follow-up period. Clinical investigation of the coincidence of primary moyamoya disease and brain stem glioma led the authors to conclude that these two diseases coexisted independently.- - - - - - - - - - ranking = 0.011178595223489keywords = cyst (Clic here for more details about this article) |
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