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Query: UMLS:C0017638 (glioma)
 30,880 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cerebral sequential scintigraphy enables a process to be described according to its hemodynamics (Stage I), its degree of vascularization (Stage II), and the extent of the localized disturbance of the blood-brain barrier function (Stage III). For a given lesion, typical scintigraphic behaviour patterns can be described. This report presents the results of a prospective series with 1722 patients examined using this method. The accuracy of the different scintigraphic diagnoses, according to tumor type, was: cerebrovascular accident with brain infarction - 92% (= CVA), metastasis - 90%, bone or meningital process - 89%, malignant glioma - 91%, meningioma - 74%, highly differentiated glioma - 67%, chronic subdural hematoma - 54%, A-V angioma - 54%, brain abscess - 45%. The differential diagnosis between brain tumor and CVA with infarction was possible in approximately 97% of the patients, the differential diagnosis of intracranial space-occupying lesion versus CVA with infarction in approximately 95%. There were 14 false positive results recorded (0.8% of the 1722 patients).
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PMID:[Reliability of positive findings in serial cerebral scintigraphy. Evaluation of a prospective series of 1700 cases]. 117 13

The demonstration and accurate localization of intracerebral mass lesions are commonly performed with computerized tomography (CT), which often cannot determine the nature of the lesion. As an aid in the differential diagnosis between brain abscess and neoplasm, the authors have evaluated both 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) leukocyte scintigraphy and the serum C-reactive protein level. Of 23 patients with intracranial mass lesions, 22 individuals showed ring-like contrast enhancement on CT scans; the one exception was a patient treated for a meningioma who had a negative CT scan despite clinical suspicion of intra- or extracranial abscess. The final diagnosis was invariably established by microscopic examination of tissue specimens. In 10 patients the final diagnosis was brain abscess; the other 13 patients harbored a brain neoplasm (glioma in nine, astrocytoma in one, and metastasis in three). The 99mTc-HMPAO leukocyte scintigraphy detected all cases of abscess. There were no false-positive results. An elevated C-reactive protein level (> 13 mg/liter) was found in all but one patient with abscess and in three patients with neoplasm; two of these three patients had dental root infections which could account for the elevation of C-reactive protein. It is concluded that 99mTc-HMPAO leukocyte scintigraphy should be performed when there is a possibility that a brain abscess may exist. Any steroid treatment should be discontinued for 48 hours prior to leukocyte scintigraphy. Also, C-reactive protein determination should be performed and is useful even when steroids are given.
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PMID:99mTc-hexamethylpropyleneamine oxime leukocyte scintigraphy and C-reactive protein levels in the differential diagnosis of brain abscesses. 140 15

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

The author examined 29 patients with the diagnosis of brain abscess by computed tomography (CT). In 28 instances the CT finding visualized a hypodense formation with an annular colouration which became more marked after administration of the contrast substance. In one patient the abscess was a hyperdense homogeneous focus. The pathological formation always behaved expansively with the surrounding oedema. The CT findings were correlated with other examination techniques (electroencephalography, cerebral angiography, cerebral scintigraphy). Visualization of the brain abscess on CT is not specific for this diagnosis. The same picture may be caused by a brain metastasis, glioma, ischaemia, an absorbing haematoma. Substrate diagnosis is not possible without a detailed case-history, clinical examination, laboratory examination and other examination methods. After introduction of CT diagnosis the mortality of patients with brain abscesses declined markedly.
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PMID:[Diagnosis of brain abscess using computer tomography]. 235 Jul 69

The sensory and motor deficits of the CNS are varied, depending on the etiologic factors and the structures involved. Nevertheless, the clinical picture is predictable, provided one has an adequate knowledge of the neuroanatomy and the functions of the different fiber tracts, nuclei, and other specific regions of the brain and spinal cord. The purpose of this section is to provide an overall view of the sensory and motor deficits of the CNS, which will enable the clinician to treat these patients in a more objective and effective manner. Etiologically, the diseases affecting the CNS can be grouped under the following categories: congenital, traumatic, inflammatory, neoplastic, and degenerative. Congenital conditions usually manifest in infancy and childhood. Examples are hydrocephalus, spina bifida, and Arnold-Chiari malformation. There are a host of other conditions, but the discussion in this article is confined to the more common entities. Traumatic conditions such as cerebral concussion, contusion, laceration, hematomas--extradural, subdural, or intracerebral--and spinal cord injuries can occur in any age group, though their incidence is higher during the more active period of life (20 to 35 years). Automobile accidents are by far the most common etiologic factor for the traumatic lesions. Others, such as falls, gunshot and stab wounds, and so forth account for the remainder. Among the inflammatory conditions, three conditions are important: brain abscess, meningitis, and transverse myelitis. Though brain abscess develops by direct extension from an adjacent focus of infection, often it forms as a result of metastatic infection, chiefly from lung abscess or bronchoectasis. It behaves more like an intracranial space occupying lesion. Of the various types of meningitis, meningococcal meningitis is the commonest. Transverse myelitis may be caused by viruses or bacteria. The clinical picture resembles that of spinal cord injury. Neoplasms of the brain and spinal cord present a wide and varied spectrum. They may be benign or malignant. Meningioma and neurofibroma are essentially benign lesions. Malignant tumors can be primary or secondary. Gliomas and specifically astrocytomas are the commonest primary malignant tumors. The commonest sites of metastatic tumors are lung, breast, kidney, and gastrointestinal tract. The clinical picture will depend on the location of the tumor and the structures pressed upon or infiltrated. Any age group can be affected. Many of the malignant tumors are slowly and relentlessly progressive. Complete surgical extirpation where possible, followed by radiation therapy, is the treatment of choice. Chemotherapy has not been of much benefit.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sensory and motor deficits of central nervous system origin. 268 39

Sequential T1 changes in brain tumor tissue after Gd-DTPA administration were investigated in 10 patients, including 4 meningiomas, 2 gliomas, 3 metastatic cerebral tumors and 1 brain abscess. T1 values were measured serially for 60 minutes following Gd-DTPA injection using a magnetic focusing technique. In vitro T1 of the whole blood samples was also comparatively examined. Time processes in the tissue-blood ratio (TBR) were calculated from two-point relaxation rates at 5 and 30 minutes. The obtained ratios of TBR were ranged from 1.0 to 3.0, probably depending on histological types of brain tumor (the value of 1.0 to 1.5 for meningioma and 1.5 to 3.0 for glioma and metastatic tumor). No significant changes in the T1 value were observed in the examined normal tissue and peritumoral edema. These results indicate that Gd-DTPA plays an important role not only as an image enhancer for tumor tissue but also as an indicator for estimating the blood-brain barrier function.
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PMID:Assessment of T1 time course changes and tissue-blood ratios after Gd-DTPA administration in brain tumors. 291 23

A rare case of hemorrhage into a brain abscess in a 23-year-old man is reported. The patient complained of headache and low-grade fever on February 26, 1986. Two days later, he developed right hemiparesis and right hemisensory disturbance with mild consciousness disturbance and was admitted to a local hospital. Seven days after the onset, he suddenly became semicomatose, developed anisocoria and was consequently transferred to the University Hospital. On admission, his temperature was 37.5 degrees C and neurological examination revealed semicoma, anisocoria and right hemiparesis without nuchal rigidity. Enhanced CT scan showed a high density area within an irregular ring enhancement at the left basal ganglia. At that time, malignant glioma was diagnosed and an emergency operation was performed by left frontotemporal craniectomy. During the operation blood clot was found in the posterior part of the basal ganglia. After operation, a histological examination was made and a brain abscess was diagnosed. Gram staining revealed gram-positive bacillus. By aspiration of the abscess and chemotherapy, recovery was gradually made. He was discharged with motor dysphasia and mild right hemiparesis three months later. Differentiation between abscess and malignant glioma and the cause of the hemorrhage are discussed.
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PMID:[A case of hemorrhage into a brain abscess]. 322 75

We report the case of a 28-year-old male who suffered a frontal penetrating gunshot injury with subsequent bifrontal brain abscess and subdural empyema, and five years later developed a large bifrontal tumour at the precise site of the meningo-cerebral scar and posttraumatic defect. Histological examination showed a glioblastoma multiforme adjacent to the dural scar and, in addition, old suture material was found within the glioma tissue. In spite of combined radiation and polychemotherapy the patient died eleven months after partial tumour resection. The temporal and local association of missile injury with subsequent recurred abscess and scar formation and the malignant glioma is highly suggestive of a causal relationship between trauma and the development of a brain tumour.
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PMID:[Glioblastoma multiforme developing after a gunshot injury of the brain (author's transl)]. 628 14

Between January 1980 and November 1982, of 152 patients admitted with a presumptive diagnosis of stroke to the University College Hospital (UCH), Ibadan, Nigeria, the final diagnosis was not 'stroke' in thirteen (8.6%). The true diagnoses in the thirteen patients were: glioma in three; meningioma, brain abscess, epilepsy and subdural haematoma in two patients each; hepatic coma and syringobulbia in one patient each. Failure to obtain adequate history, carry out thorough physical examination, and recognize valuable clues pointing to a different diagnosis were responsible for the misdiagnoses. Competent clinical acumen and expertise and selective cerebral angiography (in the absence of newer imaging techniques) would have prevented the errors.
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PMID:Misdiagnosis of stroke. 632 50

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


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