1/126. 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 = process (Clic here for more details about this article) |
2/126. Juxtaorbital en plaque meningiomas. Report of four cases and review of literature.Juxtaorbital spheroid wing or ridge meningiomas are the most common of the basal meningiomas. These are at times meningiomas en plaque, which in most patients do not have significant intracranial component. This article reviews the literature on en-plaque meningiomas and discusses the role of MR imaging and CT in the diagnosis of en-plaque meningiomas of the paraorbital region. The role of fat-suppression, gadolinium-enhanced, T1-weighted MR imaging is emphasized.- - - - - - - - - - ranking = 106.47244081686keywords = ridge (Clic here for more details about this article) |
3/126. Clear cell meningioma of the lumbo-sacral spine with chordoid features.Clear cell meningioma (CCM) is a peculiar variant that differs from conventional meningioma in affecting younger patients, arising more often in spinal or cerebellopontine locations, and showing a higher recurrence rate. Classical meningothelial areas are scarce in these tumors and the differential diagnosis with other neoplasms, particularly metastatic carcinoma, is often difficult. We report a case of clear cell meningioma from the lumbosacral spine in which location, radiologic presentation, light microscopic appearance in initial sampling, and some of the ultrastructural findings were reminiscent of chordoma. The tumor cells were diffusely positive for vimentin and very focally positive for epithelial membrane antigen. Ultrastructural demonstration of interdigitating cell processes joined by numerous desmosomes confirmed the diagnosis of CCM.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
4/126. Cerebellar papillary meningioma in a 3-year-old boy: the usefulness of electron microscopy for diagnosis.We report one case of papillary meningioma located in the posterior fossa in a 3-year-old boy. Despite a gross total resection, a major recurrence occurred 6 months later that was operated on. Eight months later, another recurrence was observed with intracranial metastases and dissemination throughout the cerebrospinal fluid. The tumor had a papillary architecture more obvious in the recurrence. Areas of necrosis were numerous. Tumor cells had large clear atypical nuclei. Many mitotic figures were seen and Ki-67 labeling index was high. The tumor cells were immunoreactive for vimentin and polysialylated neural cell adhesion molecule only, ruling out a diagnosis of ependymoma or medulloblastoma. diagnosis of meningioma was done by electron microscopy, which showed interdigitating cytoplasmic processes and cell junctions. Cytogenetic study revealed unusual karyotypic abnormalities.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
5/126. meningioma of the fourth ventricle.Meningiomas are primary meningeal based tumors of the central nervous system that rarely are located strictly within the fourth ventricle. We report a 72-year-old man operated upon for such a tumor. The pre-operative magnetic resonance images revealed a well circumscribed mass in the fourth ventricle that exhibited a low signal on T1-weighted magnetic resonance images and homogenously enhanced with gadolinium. By light microscopy the tumor was composed of tightly packed spindle cells separated by collagen. immunohistochemistry showed the tumor cells to be positive for vimentin and epithelial membrane antigen, and negative for glial fibrillary acidic protein. Electron microscopy revealed typical findings of meningioma, including interdigitating cell processes, desmosomes, and intermediate filaments. Although rare, fibroblastic meningioma must be included in the differential diagnosis of a fourth ventricular spindle cell tumor in elderly patients.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
6/126. Fibrous meningioma with tyrosine-rich crystals.A 58-year-old African-American woman presented with a 6-month history of headaches. A magnetic resonance imaging scan of the head revealed a 5-cm, enhancing dura-based mass in the left parietal region. The variably cellular tumor was composed of uniform spindle cells associated with intercellular collagen and numerous radially arranged "petal-shaped" clusters of eosinophilic crystals. The tumor was diagnosed by light microscopy as a fibrous meningioma. Ultrastructural examination disclosed cells with complex interdigitating processes connected by desmosome-like cell junctions, abundant intercellular collagen fibers, and prominent, densely osmiophilic crystals featuring radiating teardrop shaped petals emanating from a central core. A positive Millon reaction showed these crystals to consist at least in part of tyrosine. By morphology, histochemistry, and ultrastructure, the crystals resembled tyrosine-rich crystals occurring in salivary gland tumors. This is the first report of a fibrous meningioma containing tyrosine-rich crystals.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
7/126. meningioma of the pituitary stalk without dural attachment: case report and review of the literature.OBJECTIVE AND IMPORTANCE: Tumors in the suprasellar region such as adenomas of the pituitary gland, craniopharyngiomas, nonneoplastic cystic lesions (especially Rathke's cleft cysts), and meningiomas are frequently encountered in neurosurgical practice. Meningiomas originate from the arachnoid layer connected to the dura of the anterior or posterior clinoidal process, or the tuberculum, dorsum, or diaphragma sellae. Tumors originating from the pituitary stalk are rare. Such lesions may include germinomas, astrocytomas, histiocytosis X, hamartomas, and sarcoidosis. We report a patient with a suprasellar meningioma originating from the pituitary stalk with no connection to the adjacent dura. CLINICAL PRESENTATION: A 50-year-old man was assessed for impotence and loss of libido. physical examination revealed no abnormalities. Endocrinological investigations disclosed nearly complete hypopituitarism, and magnetic resonance imaging revealed a suprasellar homogeneously enhancing tumor. INTERVENTION: Complete surgical resection was performed in an endoscope-assisted right-sided supraorbital craniotomy. The tumor originated from the pituitary stalk with no connection to the surrounding dura. The histopathological diagnosis was meningioma. CONCLUSION: Although meningiomas frequently occur in the suprasellar region, this patient with a suprasellar meningioma is unique because the tumor originated from the pituitary stalk with no connection to the surrounding dura. The absence of dural attachment has been described in 43 extracerebral meningiomas, but a suprasellar location has been reported only once previously. Recognition of this phenomenon is important, because meningiomas require a different therapeutic strategy than most other tumors of the pituitary stalk.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
8/126. Intracerebral cyst associated with meningioma.A 27-year-old male had experienced an episode of severe headache and nausea, sometimes accompanied by an inability to name objects. magnetic resonance imaging showed a huge cyst within the left temporal lobe and a high degree of brain shift by it. A small round mass, which appeared to be a mural nodule, was located in the tip of left middle fossa. It was highly enhancing together with its attached dura mater, but the cyst wall was not enhanced. Sphenoid ridge meningioma with an associated intracerebral cyst or cystic glioma invading the dura mater was suspected. During surgery the small tumor was found to be arising from the sphenoid ridge and evaginating into the tip of the temporal lobe. The intracerebral cyst had a smooth surface and the tumor was visible outside the cyst through its wall. The tumor was totally removed, but the cyst wall was left without excision. Postoperatively he had no symptoms. Histological examination showed a microcystic meningioma. It is stressed that differentiations of cystic meningiomas from other cystic tumors and, of intratumoral from extratumoral cystic meningiomas using radiological, operative or histological findings are important.- - - - - - - - - - ranking = 212.94488163371keywords = ridge (Clic here for more details about this article) |
9/126. Sphenoid wing meningioma--an unusual cause of duro-optic calcification.Sphenoid ridge is the third commonest site of intracranial meningiomas. Although sphenoid ridge meningiomas often involve the optic canal, calcification along the optic nerve has not been reported with these tumors. We describe CT features of a calcified optic nerve in a patient with a calcified sphenoid ridge meningioma.- - - - - - - - - - ranking = 319.41732245057keywords = ridge (Clic here for more details about this article) |
10/126. Vascular endothelial growth factor and malignant transformation of a meningioma: case report.Although meningiomas are common benign intracranial tumors which grow slowly, we occasionally encountered aggressive or malignant ones. One of these cases showed an interesting relationship to vascular endothelial growth factor (VEGF). A 39-year-old woman underwent resection of a sphenoid ridge meningioma; the residual tumor showed evidence of malignant transformation 14 years later. We immunohistochemically examined six successive surgical specimens plus the autopsy specimen of this patient's tumor for proliferative potential, vascularity, and expression of various growth factors. In the latter stage of clinical courses, proliferative potential and vascularity was seen to increase year by year. Expression of VEGF was upregulated and correlated with vascularity. On the other hand, basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), and epidermal growth factor (EGF) were not overexpressed in this tumor. This case suggests that overexpression of VEGF and increased angiogenic potential might be involved in malignant transformation of meningiomas.- - - - - - - - - - ranking = 106.47244081686keywords = ridge (Clic here for more details about this article) |
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