Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of spontaneous pontine hematoma in young boy, with remitting and relapsing clinical course of up to 11 years, suspected of having pontine glioma or multiple sclerosis is reported. Differential diagnosis of these are mentioned with reference to our cases of pontine glioma. This patient was a man aged 16. At 5 years of age he had his first episode of double vision. 20 days after first episode, gait disturbance, left facial palsy and consciousness disturbance developed. Neurological and neuroradiological examination revealed a pontine glioma and radiotherapy was administered. All signs and symptoms resolved except for bilateral abducens palsy. Four months later, he again complained of gait disturbance and facial palsy. Examination revealed bilateral conjugate ocular palsy, left facial palsy and cerebellar ataxia. These symptoms again resolved spontaneously, except for bilateral abducens palsy. At age 16 years, having been asymptomatic for 10 years, he suddenly noticed loss of taste. At that time sensory disturbance of the left side of himself, right hearing disturbance, dysarthria and retardation urinae. Neurological examination revealed bilateral optic atropy, bilateral abducens palsy, left facial palsy, right hyperacuisis, dysarthria, left hemiparesis, hypesthesia of the left side of the body and left cerebellar ataxia. The vertebral angiography was no evidences of mass lesion and vascular anomalies. The computed tomography demonstrated a pontine hematoma. Conservative therapy was performed and these symptoms cleared off except for bilateral abducens palsy.
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PMID:[A case of spontaneous pontine hematoma in patient suspected of pontine glioma and multiple sclerosis (author's transl)]. 72 72

A case of cystic optic glioma involving chiasma and bilateral posterior optic pathway was reported. A 26-year-old male was admitted to our hospital complaining of dysarthria and left hemiparesis. CT, MRI revealed a cystic tumor at the right basal ganglia to midbrain, a calcified one at the bilateral optic tract and left temporal to thalamic region, and a small one at the chiasma. Radiotherapy and chemotherapy were performed because anaplastic astrocytoma was suspected after stereotactic biopsy of the tumor at the right basal ganglia. The subsequent MRI showed continuity among the above three lesions to be well defined. About 2 years later, however, enlargement of the cyst, tumor invasion beyond the optic pathway and growth of the chiasmal lesion were noted, and direct surgery to the chiasmal lesion was performed. The chiasma was swollen and grayish soft tumor tissue was partly resected after aspiration of the intrachiasmal cyst. The definitive pathological diagnosis was pilocytic astrocytoma. This case was designated as a peculiar optic glioma in the following respects; the patient was an adult man suffering from dysarthria and left hemiparesis, the tumor involved not only the chiasma and the bilateral optic tract, but also the outside optic pathway and was accompanied by a large cyst.
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PMID:[A case of cystic optic glioma involving chiasma and bilateral posterior optic pathway]. 144 96

CT guided stereotaxic biopsy (aspiration) has been proved as a procedure of choice in the assessment and treatment of a deep-seated sinusogenic, brain abscess in a 54-year old man. The clinical features were atypical; massive neurological deficits (left-side spastic hemiplegia, dysarthria, urinary incontinence) without signs and symptoms of infectious disease. The clinical course and CT finding primarily showed a metastatic neoplastic process surrounded by a large edema in the right fronto-parietal parts so that an abscess or less probably glioma were also considered. From the neurosurgeon's point of view the process was inoperable because of the localization and unknown etiology. Due to recent studies, CT-guided stereotaxic biopsy confirmed the diagnosis of the brain abscess, even when the pus was evacuated by aspiration. CT-guided stereotaxic aspiration together with anti-edematose and target antibiotic therapy, has made possible impressive, complete recovery within ten days. It has been achieved by intravenous administration of Penicillin G (24 million UI per day) during 3 months. The control CT findings and the following clinical course confirmed the resolution of the abscess. The aim was to show a case of a successfully treated brain abscess with CT- guided stereotaxic biopsy (aspiration) and to present great advantages of this method primarily as a safe and effective technique which makes possible minimal traumatization of a patient and fast recovery with minimal risk of invalidity.
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PMID:[CT guided stereotaxic biopsy in the treatment of solitary brain abscesses]. 207 34

A case of cryptococcosis simulating brain tumor was reviewed. A 66-year-old female was admitted to our hospital with chief complaint of vertigo, gait disturbance and dysarthria. These symptoms started about one year before admission and worsened. Vomiting and urinary incontinence appeared. Neurological examination revealed left cerebellar ataxia and dysarthria. In plain CT (computerized tomography) irregular ill-defined low density area was noted in the cerebellar vermis and bilateral cerebellar hemispheres. And slight ventricular dilatation was found. Irregular shape of ring-like enhancement corresponding to capsule and patchy or mottled enhancement inside the tumor were seen. Suboccipital craniectomy was performed and yellowish necrotic tumor with hard capsule was removed. Histological diagnosis was not neoplasm or tuberculoma. Postoperatively liver function progressively worsened. She died due to disseminated intravascular coagulation. Autopsy revealed typical liver cirrhosis without malignant change. 3.0 X 2.5 cm sized, slightly hard, yellowish lesion was found on upper part of cerebellar hemispheres. This had extremely necrotic tissue and a great number of cryptococcus neoformans were found. And other intracranial lesion was not confirmed. Finding of pulmonary cryptococcosis was not gained. Our case is very rare because of solitary cerebellar abscess and absence of meningitic episode or pulmonary cryptococcosis. There are three types of inflammation in cerebral cryptococcosis. The commonest manifestation is the meningitic type, the second mode is granulomatous lesion and the third and the least presentation is intracranial abscess formation. CT reveals various findings according to clinical stage. CT findings are those of meningitis, meningoencephalitis, granuloma and abscess. Cryptococcal granuloma or abscess often simulates brain abscess, glioma and metastatic brain tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of cerebral cryptococcosis, with special reference to computerized tomography findings]. 646 65

A surgically treated case of ventrally exophytic pontine glioma is reported. A 49-year-old woman, complaining of dysarthria, dysphagia and gait disturbance, was admitted to our department. Her past history included bronchial asthma. Plain skull x-p and tomography revealed destruction of the dorsum sellae and upper clivus. CT demonstrated an enhanced oval mass at the ventral side of the upper brainstem. The mass was severely compressing the brainstem dorsally. MRI revealed a low-intensity band between the tumor and the brainstem. Dynamic MRI demonstrated a pattern of rapid increasing and slow reduction. Cerebral angiogram demonstrated a paradoxical sign that pontine branches were located anterior to the basilar artery. The finding demonstrated that the tumor was an intraaxial mass. The first operation was performed by the orbitofrontomalar approach. On the trans-sylvian route, the tumor was removed partially with CUSA and neuronavigation system. Its histology was astrocytoma grade III. Radiation therapy was added. The patient's symptoms aggravated again. On the second operation, the transtemporal route with tentorial resection was chosen. Under a wide visual field, intracapsular subtotal resection of the tumor was performed. Interferon therapy was added. She was discharged to her home with no neurological deficits. Ventrally exophytic pontine glioma is very rare. Low-intensity band of MRI, a sign of extraaxial mass, was visualised in our case. On the other hand, cerebral angiogram demonstrated a paradoxical sign. This sign suggested that the tumor originated from the brainstem. With update skull base surgery and neuronavigation system, surgical therapy of ventrally exophytic pontine glioma is safe and effective.
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PMID:[A surgically treated case of ventrally exophytic pontine glioma]. 747 14

A rare case of glioblastoma fed by meningeal branches of the external carotid artery was reported. A 63-year-old female was transferred to our hospital suffering from gait disturbance and dysarthria. CT and MRI revealed brain tumor and paratumoral hemorrhage with a large cyst that was heterogeneously enhanced and existed in the right fronto-temporal region. Right external carotid arteriography demonstrated the tumor stain markedly fed by the right middle meningeal artery and the accessory meningeal artery. Subtotal removal operation was carried out uneventfully using the right fronto-temporal craniotomy. The histological diagnosis was glioblastoma. After the operation the patient was in good condition, and was transferred to another hospital for the purpose of the synchronized chemoradiotherapy. It is well known that any glioma invades the meninges. However, we rarely encountered an intra-axial glioma fed by a meningeal blood supply. A meningeal-invaded glioma may make difficult its differentiation from meningioma. We concluded that there is necessity for close examination of the intra-axial brain tumors invaded and fed by meningeal blood supply.
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PMID:[Glioblastoma fed by meningeal branches of the external carotid artery: a case report]. 1036 56

A 49-year-old woman with 6 months history of body weight loss, muscle weakness, and dysarthria, was found with respiratory arrest and resuscitated in the morning of January 1999. An MRI brain scan revealed diffuse swelling and T2/FLAIR high signal intensity with mild Gadolinium enhancement in the lower pons and medulla oblongata. Although the histological diagnosis could not be obtained, glioma (astrocytoma) was suspected. In the morning of July 3rd she presented sweating and cyanosis. Her arterial oxygen saturation was 18%. When we asked her to breathe more, she kept breathing and oxygen saturation was normalized. However, she could not breathe at all when she fell asleep without stimulation. She was kept under respiratory support for 2 months. Her symptoms improved with fluctuating course after 70 Gy of radiation therapy. Ondine curse is one type of sleep apnea syndrome, defined as the selective disturbance of autonomous breathing. Surgical operation and stroke are the reported causes of this syndrome. Brainstem tumor is relatively common cause for children's Ondine curse. On the other hand, it rarely causes adult's Ondine curse as a main symptom.
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PMID:[A case of Ondine curse associated with a medullary tumor]. 1121 2

Functional neuroimaging has improved pre-planning of surgery in eloquent cortical areas, but remains unable to map white matter. Thus, tumour resection in functional subcortical regions still presents a high risk of sequelae. The authors successfully used intraoperative electrical stimulations to perform subcortical language pathway mapping in order to avoid postoperative definitive deficit, and correlated these functional findings with the anatomical location of the eloquent bundles detected using postoperative MRI. At the same time, this also improved knowledge of fibre connectivity. Thirty patients harbouring a cortico-subcortical low-grade glioma in the left dominant hemisphere were operated on whilst awake using intraoperative electrical functional mapping during surgical resection. Language cortical sites and subcortical pathways were clearly identified and preserved in the 30 cases. The anatomo-functional correlations between data obtained using intraoperative subcortical mapping and postoperative MRI revealed the existence in all patients of common pathways which seem essential to language. This was shown by inducing reproducible speech disturbances during stimulations as follows: the subcallosal fasciculus (initiation disorders), the periventricular white matter (dysarthria), the arcuate fasciculus and the insular connections (anomia). Clinically, all patients except three presented a transient postoperative dysphasia, which resolved within 3 months. On control MRI, 14 resections were total and 16 subtotal due to infiltration of functional bundles described above. It is recommended that the combination of the techniques as described could prove ideal for future non-invasive reliable subcortical mapping both in healthy volunteers and in patients harbouring a (cortico)subcortical lesion in order to optimize surgical pre-planning.
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PMID:Intraoperative mapping of the subcortical language pathways using direct stimulations. An anatomo-functional study. 1183 4

We report a case with double primary intracranial tumors of different cell types without phacomatosis. The patient was hospitalized due to progressive memory impairment, headaches, dysarthria and right hemiparesis. Initial computed tomographic (CT) examinations revealed a large hyperdense tumor over the right frontal lobe, suggestive of an extra-axial meningioma. Additionally, there was unusual brain edema in the contralateral hemisphere that subsequently proved to originate from an intrinsic tumor. Staged craniotomies were used to treat the patient. Pathological examinations confirmed the two tumors to be a meningioma and a glioblastoma multiforme, respectively. The patient made an uneventful recovery after treatment. Although meningioma and glioma represent two common primary intracranial tumors, the simultaneous development of the two tumors is rare. A randomly occurring event most likely accounted for this linkage in the patient. We suggest that extraordinary brain edema far remote from the primary brain lesion warrants special attention for identifying other potentially undetected lesions.
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PMID:Two primary brain tumors, meningioma and glioblastoma multiforme, in opposite hemispheres of the same patient. 1238 24

Although a cortical network involving Broca's area and the supramarginal gyrus (SMG) was widely studied using neurofunctional imaging, the functional connectivity underlying this so-called articulatory loop remains poorly documented. We describe a patient operated on for a glioma invading the left parietal operculum, using intraoperative electrical functional mapping under local anesthesia. Following the identification of cortical language sites within Broca's area and SMG, the subcortical pathways connecting these regions were detected and preserved during the resection. Postoperatively, the patient presented a slight dysarthria, then recovered. This is the first report of direct tracking of the subcortical connectivity underlying the fronto-parietal articulatory loop, allowing to better understand the pathophysiology of this network and the consequences of its damage.
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PMID:The articulatory loop: study of the subcortical connectivity by electrostimulation. 1456 39


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