1/244. Early glial tumor metastases through a ventriculo-atrial shunt.A girl of 12 with a pontine polymorphous astrocytoma diffusely metastasizing to the spinal cord leptomeninges suddenly died 20 hours after the insertion of a right ventriculo-atrial shunt. Many severely damaged glial neoplastic cells were found in the blood vessels of the lung and liver.- - - - - - - - - - ranking = 1keywords = spinal cord, spinal, cord (Clic here for more details about this article) |
2/244. Gliomatosis cerebri: cytologic and autopsy findings in a case involving the entire neuraxis.We describe the case of a 7-year-old girl who was clinically diagnosed as having a pontine glioma based on magnetic resonance imaging studies. Neoplastic cells were identified upon cytologic examination of cerebrospinal fluid. autopsy studies revealed an anaplastic astrocytoma (WHO grade III) diffusely infiltrating the cerebral hemispheres, brain stem, cerebellum, leptomeninges, and spinal cord to the level of the conus medullaris. The Ki-67 labeling index focally approached 30%. Although many of the neoplastic cells displayed elongated twisted nuclei reminiscent of microglia, these cells stained intensely for glial fibrillary acidic protein, supporting an astrocytic origin. Unusual features of this case of gliomatosis cerebri include involvement of the entire central neuraxis, correlation with pre-mortem lumbar puncture cytology, and a markedly elevated Ki-67 labeling index.- - - - - - - - - - ranking = 1.1878948244899keywords = spinal cord, spinal, cord (Clic here for more details about this article) |
3/244. Intra-operative optical method using intrinsic signals for localization of sensorimotor area in patients with brain tumor.The purpose of this study is intra-operatively to localize the sensorimotor area by intrinsic optical method detecting the changes in regional cerebral blood flow (rCBF) and cortical temperature following neuronal activity during median nerve stimulation. In 18 patients with brain tumors located around the sensorimotor cortex, cortical recording of somatosensory evoked potentials (SEPs) was performed and localized changes in rCBF during median nerve stimulation were measured by a laser-Doppler flowmeter on the locations of SEPs and around the activation area obtained by functional magnetic resonance imaging (fMRI). In two patients, cortical thermomapping was also performed during median nerve stimulation. In fMRI study, the significant activation area of sensorimotor could be obtained in 17 of 18 patients. In cortical recording of SEPs, the polarity reversal of N20 and P20 was observed in 14 of the 18 patients. In 9 of the 14 patients in whom SEPs could be recorded, the localized changes in rCBF, corresponding to the stimulation, were detected in the N20 area. In 2 of the 4 patients in whom N20 could not be recorded successfully, the localized changes in rCBF could be detected. The increase in rCBF during the stimulation was 18.3% /- 5.3% (mean /- SD, n = 11). Thermomapping could demonstrate the localized area, where the increase in rCBF was also detected, by observation of the changes in cortical temperature during the stimulation. The intra-operative intrinsic optical method detecting rCBF and cortical temperature in combination with recording of SEPs may be considered useful for brain functional localization related to neurosurgical disorders.- - - - - - - - - - ranking = 0.2367125294319keywords = cord (Clic here for more details about this article) |
4/244. Aspecific inflammatory lesion (histiocytosis?) simulating intramedullary astrocytoma. Case report.We report an exceptional case of aspecific inflammatory lesion of the thoracic spinal cord simulating an intramedullary glial tumor. Patient history was characterized by progressive spastic paraparesis with urinary incontinence; MR imaging (T4-T5) showed an enhancing intrinsic mass lesion. Myelotomy enabled partial resection of grayish astrocytoma-like tissue. Only light microscope examination was possible and disclosed aspecific inflammatory tissue composed of eosinophils, lymphocytes and histiocytes. After the operation, the patient improved promptly and no further therapy was administered. Control MRI after four months, one year and two years showed complete disappearance of the intramedullary mass lesion and the patient remained clinically stable with no other signs of disease. Since electron microscopic as well as immunohistochemical studies were not available, a definitive histological diagnosis was not possible. However on the basis of some clinical similarities with cases of isolated histiocytosis X of the CNS reported in the literature, we suggest that a diagnosis of isolated intramedullary eosinophilic granuloma could be reasonable.- - - - - - - - - - ranking = 1keywords = spinal cord, spinal, cord (Clic here for more details about this article) |
5/244. Congenital intramedullary tumor with neonatal manifestations.The authors report on a 45-day-old boy with a congenital intramedullary tumor with clinical manifestations since birth. neurologic examination disclosed severe bilateral lower-limb hypotonia and diplegia, with exacerbated deep tendon reflexes and clonus associated with severe pain at manipulation. Further evaluation of this patient included screening for infections, computed tomographic scan, myelography, and somatosensory evoked potentials. The definite diagnosis was a solid holocord astrocytoma. This report discusses a rare disorder in the neonatal period and makes other medical practitioners aware of this diagnosis. Previously published literature is also reviewed.- - - - - - - - - - ranking = 0.04734250588638keywords = cord (Clic here for more details about this article) |
6/244. spinal cord astrocytoma: response to PCV chemotherapy.Information regarding the value of chemotherapy for spinal cord astrocytomas that progress after irradiation is limited. We describe a patient whose conus medullaris astrocytoma responded to PCV (procarbazine, lomustine, and vincristine) chemotherapy after failing radiation and cisplatin-based chemotherapy. PCV should be considered in patients with progressive spinal cord astrocytomas.- - - - - - - - - - ranking = 2.1893700235455keywords = spinal cord, spinal, cord (Clic here for more details about this article) |
7/244. Extreme lateral supracerebellar infratentorial approach to the posterolateral mesencephalon: technique and clinical experience.OBJECTIVE: Lesions situated posterolaterally along the mesencephalon present neurosurgeons with a special challenge. The midline and paramedian variations of the supracerebellar infratentorial approaches do not adequately expose this region. The subtemporal approach risks injury to the vein of Labbe. An extreme lateral supracerebellar infratentorial approach with more radical resection of bone superiorly and laterally, and skeletonization of the sigmoid and transverse sinuses, was used to approach lesions at this location in eight methods: Five cavernous malformations, two juvenile pilocytic astrocytomas, and one peripheral superior cerebellar artery aneurysm located in this region were approached in eight patients. In this extreme lateral approach, the sigmoid sinus is unroofed more superiorly and the bone flap includes not only a posterior fossa craniotomy but also a portion that extends just above the transverse sinus. The dural opening is based along the transverse and sigmoid sinuses. After the cerebrospinal fluid has been drained, the lateral aspect of the brainstem is approached via the cerebellar surface. A proximal tentorial incision offers additional rostral exposure where needed. RESULTS: Seven patients in this series underwent successful resection of their lesion. The remaining patient's aneurysm was clipped successfully with no major complications. CONCLUSION: The extreme lateral supracerebellar infratentorial approach differs from the midline and paramedian supracerebellar infratentorial variants in the area of exposure, patient positioning, and location of the craniotomy. The technique is effective for approaching the posterolateral mesencephalon.- - - - - - - - - - ranking = 0.18789482448995keywords = spinal (Clic here for more details about this article) |
8/244. Neuroendoscopic biopsy of tectal glioma: a case report.OBJECTIVE AND IMPORTANCE: A type of intrinsic dorsal midbrain glioma known as benign tectal glioma can cause obstructive hydrocephalus. Because of its slow progress and relatively good prognosis, initial treatment should be cerebrospinal fluid diversion and biopsy. CLINICAL PRESENTATION: We report a 24-year-old man with obstructive hydrocephalus from a tectal glioma, who was admitted to the hospital for malfunction of a shunt placed 16 years previously. INTERVENTION: magnetic resonance imaging demonstrated enlargement of the dorsal midbrain associated with increased signal intensity on T2-weighted images and fluid attenuation inversion recovery (FLAIR) images. No enhancement occurred with contrast administration. We performed a neuroendoscopic third ventriculostomy and biopsy of the tumor. Histologic examination of the specimen obtained disclosed a low-grade astrocytoma. No postoperative neurologic complications occurred. CONCLUSION: FLAIR images were superior to T2-weighted images in demonstrating abnormal intensity in the dorsal midbrain. neuroendoscopy confirmed a yellowish tumor inferior to the posterior commissure occluding the entrance of the aqueduct, an observation useful in planning biopsy of the lesion. As the tumor apparently had existed for a number of years, the case supports the notion that the prognosis associated with these tumors is good.- - - - - - - - - - ranking = 0.18789482448995keywords = spinal (Clic here for more details about this article) |
9/244. A new homeopathic approach to neoplastic diseases: from cell destruction to carcinogen-induced apoptosis.Neoplastic diseases are now among the most commonly seen conditions. Orthodox, non-surgical approaches, including chemotherapy and radiotherapy, have variable results, but many adverse affects that limit their use. These are sometimes the direct cause of death. More patients are choosing alternative treatments, mainly the homeopathic and herbal-nutrition approach. homeopathy does not have highly effective remedies for cancer in its literature, and has been limited to palliating the adverse effects of chemo/radiotherapy. research into substances that can produce neoplastic diseases (carcinogens), may lead to them being used to treat the cancer they cause, according to the principle of similarity. I have used ultra-low doses (1 x 10(-10) to 10(-12) molar) of chemical carcinogens for 3-24 months, which have been given to cancer patients, usually in conjunction with conventional treatment. Using this procedure, complete remission or life extension has been achieved for some cancer cases. Three clinical cases are presented: a man with undifferentiated lung cancer; a child with an astrocytoma and a woman with leiomyosarcoma.- - - - - - - - - - ranking = 0.04734250588638keywords = cord (Clic here for more details about this article) |
10/244. spinal cord gliomas: management and outcome with reference to adjuvant therapy.The authors review their experience with 19 consecutive cases with either astrocytic tumour (glioblastoma multiforme one, anaplastic astrocytoma one, astrocytoma 4, pilocytic astrocytoma 4) or ependymoma (10 tumours in 9 patients) of the spinal cord who were treated during the period from 1982 to 1996. The patients included 10 male and 9 female patients with a median age of 38 years. The main tumour locations included the cervicomedullary region 5 the cervical cord (8), the thoracic cord (5) and one each in the thoracolumbar region and conus medullaris. While a total removal of the tumour was achieved in 8 out of 10 ependymomas, the initial treatment for astrocytic tumours was a partial resection in 5, and biopsy in the remaining 5. As adjuvant treatment, 8 patients received radiation therapy and 2 received chemotherapy. Two patients with an astrocytic tumour received chemotherapy only, while the remaining 9 received neither radiation therapy nor chemotherapy initially. After these treatments, 6 out of the 8 patients with low grade astrocytoma have remained alive for 1.3-12.6 years, while 2 patients with high grade astrocytic tumours died within 15 months following surgery. Eight out of 9 patients with an ependymoma have remained alive for 3.0-12.3 years, while one committed suicide 2 years after surgery. As a result, 14 patients are still alive; half of them are accompanied by a mild neurological dysfunction, while the remaining one has a moderate deficit. The postoperative results and the rationale for surgery is discussed, and an approach for utilising adjuvant therapy for high grade tumours is also suggested.- - - - - - - - - - ranking = 1.2840550353183keywords = spinal cord, spinal, cord (Clic here for more details about this article) |
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