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Query: UMLS:C0017636 (glioblastoma)
 18,345 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On the basis of 346 glioma patients operated on in the years 1969-1983, the frequency of epileptic seizures and their importance for the diagnosis as well as the causes of the delay in clearing up the clinical picture were ascertained. Of the 226 patients with an astrocytoma, 51.5 per cent had one or several epileptic fits in the pre-operative period. For the 99 glioblastoma patients, the seizure rate was 33.7 per cent and for the 21 patients with an oligodendroglioma it was 69 per cent. Although in about 80 per cent of the cases epileptic fits were the first symptom of the disease, this important clinical sign led in only 30 per cent to a causal treatment. In another 20 per cent of the courses, the final clarification was initiated by an increase in the frequency of the fits or a change of the kind of the fit. In the remaining 50 per cent of the glioma patients it was only after the additional occurrence of neurological disturbance that the diagnosis could be verified and surgical treatment carried out.
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PMID:[Diagnostic value of epileptic seizures in cerebral gliomas]. 383 99

Twenty-five adults who harbored malignant gliomas received 72 courses of intraarterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) (100 mg/m2) and 67 courses of systemic vincristine (1.0 mg/m2) and procarbazine (100 mg/m2) as induction therapy (BVP) followed by 106 courses of systemic 1-(2-chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea (methyl-CCNU) (130 mg/m2), vincristine, and procarbazine as maintenance therapy (MVP). With a 6-week interval between each treatment, the median and range for the number of courses of BVP were 3 and 1 to 4 and those for MVP were 3 and 0 to 14, respectively. Fifteen patients (60%) responded to both BVP and MVP, and 10 (40%) did not. The overall median survival time was 12.7 months (range, 1.8 to 48.5+ months). Two of 3 patients who had recurrent gliomas responded and survived for 37+ to 45+ months. Seven of 10 who had nonirradiated glioblastomas responded and survived for 9 to 22 months. Four who had nonirradiated anaplastic astrocytomas all responded and survived for 38+ to 48.5+ months. Two who also received radiotherapy (1 glioblastoma and 1 primitive neuroectodermal tumor) benefited and survived for 16.9 and 28.5+ months. All who did not respond favorably died within 8 months. During the infusion of BCNU, complications included transient orbital and head pain, periorbital and scleral erythema in all patients, and a focal seizure in 1 (4%). During the 6-month induction periods, leukopenia and thrombocytopenia occurred in 1 (4%), deep vein thrombosis occurred in 9 (36%), pulmonary emboli occurred in 8 (32%), upper respiratory infections occurred in 6 (24%), pneumonia occurred in 9 (36%), and herpes zoster occurred in 1 (4%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intraarterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and systemic chemotherapy for malignant gliomas: a follow-up study. 631 73

This is a case-control study of 160 persons with glioblastoma and 128 of their "best friends" as controls. Subjects came mainly from greater Boston, and data were gathered by questionnaire and telephone interview. Among those who had had a "severe" head injury at age 15 or later, the age-adjusted rate ratio (RR) of glioblastoma was 10.6, p = 0.004. There were six cases and no controls who had seizures for 15 or more years. The related RR is inestimable, but has a p value of 0.03. We could not evaluate whether the latter association implies a direct relationship between the causes of seizures and the causes of glioblastoma, or if it reflects the effect of another factor, such as medications to control the seizures.
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PMID:Head trauma and seizures as risk factors of glioblastoma. 649 5

Ten (23%) patients out of 43 with malignant glioma developed meningeal gliomatosis during the follow up period of at least one year. The duration between the first surgery and diagnosis of meningeal gliomatosis ranged from one to 78 weeks (median 45 weeks). In younger age group less than 20 years old, 5 (56%) out of 9 patients had meningeal gliomatosis, and on the contrary the incidence was lower in older age group above 20 years old (5 of 34, 15%). Seven (22%) out of 32 male and 3 (27%) out of 11 female patients developed meningeal gliomatosis. The primary tumor location were frontal lobe in 4 cases (including one bifrontal tumor), temporal in 2, parieto-occipital in 1, thalamus in 1, midbrain in 1, and cerebellar hemisphere in 1, respectively. Histologically, 7 tumors were anaplastic astrocytoma, and 3 were glioblastoma. The characteristic neurological findings observed during the course of meningeal gliomatosis were abnormal mental status (80%), cranial nerve palsies (50%), paraplegia (60%), stiff neck (80%), seizure (50%), and respiratory disturbance (80%), CSF cytology was positive in all 9 patients tested. CT scan demonstrated hydrocephalus (70%), and diffuse contrast enhancement of ventricular wall (60%) and basal cistern (10%). In 2 cases, block and irregular filling defect were seen by myelography. Six patients were treated by irradiation to the whole brain and/or spine, and 5, by intrathecal chemotherapy with methotrexate, cytosine arabinoside and bleomycin. However, all patients died of the tumor one to 46 weeks (median 18 weeks) after the diagnosis of meningeal gliomatosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical studies of meningeal gliomatosis]. 649 23

A 44-year-old man had frequent episodes of piloerection, or " gooseflesh ." Clinical and EEG evidence suggested that the attacks were pilomotor seizures, originating in the right temporal lobe. The cause was a glioblastoma. Paroxysmal piloerection is a rare manifestation of epilepsy.
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PMID:Pilomotor seizures. 653 52

Cerebral aspergillosis currently occurs most frequently with disseminated aspergillosis in immunocompromised hosts. Twelve patients with cerebral aspergillosis in this setting were seen over 10 years. Underlying illnesses were renal transplantation in six cases and one case each of subacute hepatic necrosis, head trauma, glioblastoma, microglioma, and esthesioneuroblastoma. All patients were receiving high dose steroid therapy except one who had ectopic ACTH syndrome. Eleven patients were receiving broad spectrum antibiotics. All patients were febrile and developed progressive pulmonary infiltrates preceding or coincident with neurologic symptoms. Sudden onset of neurologic deficits or seizures occurred in nine of 11 clinically analyzable cases. Brainstem or cerebellar signs and symptoms were a presenting feature in three cases and were eventually seen in five cases. Cranial computerized tomography in four cases showed low absorption areas with minimal enhancement and little mass effect. Neurologic deterioration was rapid with nine of 11 patients dying within 6 days of onset. Neuropathologic examination showed multiple abscess formation in 11 cases and prominent blood vessel invasion in all cases. The sudden onset of stroke-like deficits and brainstem findings in a febrile immunocompromised host with pulmonary infiltrates suggests the diagnosis of cerebral aspergillosis. Two cases of aspergillus meningitis were also seen, one postoperatively.
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PMID:Aspergillosis of the nervous system. 720 Feb 4

The incidence of supratentorial brain tumors revealed by epileptic seizure is certainly underestimated in developing countries due to the lack of adequate diagnostic facilities. This report describes 10 cases of tumor-related epilepsy observed in Gabon over a 54-month period. Tumor-related seizures accounted for 5% of patients hospitalized for epilepsy in neurosurgical and neurologic units in Gabon during the study period. In two patients who refused surgery, diagnosis of the tumor was made solely on angiographic findings. Surgery was performed in 8 patients based on electroencephalographic and arteriographic findings. There were 4 astrocytomas, 3 meningiomas, and 1 glioblastoma. One patient died 8 days after the procedure due to convulsions. Another patient was lost from follow-up three months after the procedure. The remaining 6 patients are asymptomatic with follow-up periods ranging from 10 to 72 months (mean: 40.6 months). The value of early diagnosis and resection as well as post-operative use of antiepileptic drugs is emphasized.
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PMID:[Tumor-related epilepsy in adults in Gabon: diagnostic problems and therapeutic management]. 763 14

Pleomorphic xanthoastrocytoma (PXA) is a rare glial tumour typically occurring in young patients in the first three decades, having a superficial cortical location and with a relatively good prognosis for long-term survival. Four cases are reviewed. The magnetic resonance imaging (MRI) appearances, which in PXA have been reported only once before, are described in three cases. The fourth case was studied by computed tomography and angiography. One patient developed seizures at age 2 days and was aged 2 1/2 years at presentation. This is the youngest patient with PXA yet reported. Three of the four patients had seizures, but in one case the tumour was not the cause of the seizures. Review of the literature has revealed 47 reported cases. Mean age at presentation was 14.3 years. Epilepsy occurred in 78%. Seventeen patients were alive without recurrence at a mean of 7.9 years after diagnosis and 10 patients died at a mean of 7.4 years after diagnosis. Thirteen cases had recurrence at a mean of 6 years after surgery and in five instances the recurrence was in the form of a glioblastoma. Resections which were grossly total were less likely to develop recurrence than those which were subtotal. Complete gross resection of tumour offers the best therapeutic option in PXA.
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PMID:Pleomorphic xanthoastrocytoma--report of four cases, with MRI scan appearances and literature review. 771 64

We studied the electrophysiological properties of cells from human glioblastomas obtained after surgery. The membrane currents were compared in cells of acute tissue slices and primary cultures using the whole cell mode of the patch-clamp technique. Very strikingly, in about a third of the tumor cells in situ and in vitro, depolarizing voltage steps elicited large, tetrodotoxin-sensitive inward currents with a threshold of about -30 mV, indicating the presence of voltage-gated sodium channels. In addition, three types of potassium currents, a delayed rectifying, an A-type, and an inward rectifying, were observed. Such a set of voltage-gated channels is characteristic for neurons. Indeed, in these glioblastoma cells, depolarizing current pulses in the current clamp mode were able to generate action potentials with properties similar to those observed in neurons. We interpret this finding as the ability of glioblastoma cells to acquire neuronlike properties but retain some glial features, since they still express markers typical for astrocytes and their precursors. The role of sodium channels in glioblastoma cells is unclear at this moment and needs further investigation. Our findings, however, imply that the tumor tissue can be intrinsically excitable and that neoplastic glial cells themselves may be an etiologic factor for epileptic seizures.
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PMID:Action potential-generating cells in human glioblastomas. 905 38

Composite pleomorphic xanthoastrocytoma (PXA)-ganglioglioma (GG) is a rare recently described entity. Only three examples have been documented, one of which showed evidence of malignant transformation. We report an additional four cases and update the literature. With the exception of an 82-year-old man, all patients have been under 30 years of age. The temporal lobe was involved in three cases and cerebellum in another three. Radiologic features were those common to PXA and GG. Histologically, all were "collision tumors" composed of abutting, although spatially distinct, PXA and GG components. In two cases, the second element was only recognized at reexcision or recurrence. Histologic anaplasia, always in the PXA component, was evident as brisk mitotic activity and/or necrosis in five cases. Of the seven patients, one died of disease 17 years after the onset of seizures and after multiple recurrences, the last of which largely resembled glioblastoma. We conclude that the composite PXA-GG is a rare neoplasm that shares many features of its individual components. In addition to its temporal lobe predilection, the cerebellum is frequently affected. As when it occurs in isolation, the PXA component of composite PXA-GG possesses the potential for malignant transformation.
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PMID:Composite pleomorphic xanthoastrocytoma and ganglioglioma: report of four cases and review of the literature. 923 32


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