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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Brain tumors are, after leukemias, the most frequent fatal neoplasms of infancy. The clinical features and symptoms are often markedly different from those observed in the adult forms, according to the peculiar anatomy and behaviour of the child. Persistent headache, vomiting, astenia , behavioral alterations may be the precocious findings. Later, some more specific and suggestive signs such as strabismus, dyplopia , fast head size increase, funduscopic alterations, ataxia, paresis and nystagmus may be observed. On their appearance a prompt diagnostic work-up should be performed. The tumors of the posterior fossa (cerebellar astrocytoma and medulloblastoma, brainstem glyoma , hependimoma in decreasing order of frequency) generally cause precocious symptoms because of the small dimension of the subtentorial space; the presence in this region of several fundamental nuclei and pathways may explain how also small tumors may cause severe deficits. Supratentorial tumors (astrocytoma, malignant glyoma , hependimoma , craniofaringioma ) often show a more prolonged latency and may begin with signs of endocranial hypertension, seizures, or sometimes with hormonal troubles according to the involved anatomic structures. Hypothalamic astrocytoma is responsible of an extreme weight loss as far as to a cachetic status, due to the hyperincretion of GH. Finally, plexus papilloma, dermoid, optic nerve glyoma , oligodendroglyoma , germinoma, teratoma are responsible of a small number of child brain tumors, with different localization and symptomatology.
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PMID:[Clinical course of brain tumors in childhood]. 673 95

Brain tumors associated with tuberous sclerosis are often found in the wall of the ventricles near the foramen of Monro and present with symptoms of increased intracranial pressure due to occlusion of the CSF pathway. The authors reported a case of such a brain tumor which presented predominantly focal neurological signs because of a large cyst function. This 8-year-and-4-month old girl experienced her first seizure attack at the age of 1-year-and-3-month. Six moths before admission, she complained of headache which lasted for several days. CT scans at that time revealed mass lesions in both lateral ventricles which were mildly dilated. A round low density area, considered to be a cyst, was found lateral to the calcified tumor of the left lateral ventricle extending into the adjacent parenchyma. Two months later, she noticed weakness in her right extremities, difficulty in buttoning and tendency to stumbling, and these were slowly progressive. Her past history was non-contributory. CT examinations of her mother and elder brother with adenoma sebaceum indicated that both had multiple calcifications in the ventricular walls and they were clinically diagnosed as having an incomplete form of tuberous sclerosis. On admission to the Department of Neurosurgery, Shinshu University Hospital on March 23, 1979, the patient was noted to have right hemiparesis and hyper-reflexia. She could barely walk but was unable to write with her right hand. Fundoscopic examination was normal. On general physical examinations, characteristic skin lesions including adenoma sebaceum, shagreen patch and depigmented patches were found. The second CT scans taken at the time of admission revealed that the low density area markedly enlarged, while the size of the tumors and ventricles remained essentially unchanged. A left parietal craniotomy was performed with a preoperative diagnosis of cystic tumor of the lateral ventricle associated with tuberous sclerosis. The tumor in the left lateral ventricle was found extending from the trigone to the anterior horn beyond the foramen of Monro. Histopathological diagnosis of typicaL benign giant-celled astrocytoma was made. The immediate postoperative course was uneventful except for a temporary worsening of the right motor weakness. V-P shunt was necessary because she developed signs and symptoms of increased intracranial pressure due to hydrocephalus two weeks after operation. At the time of dismissal from the hospital one month postoperatively, she was neurologically free except for the mild right hemiparesis. To the best of our knowledge, the present case is the first reported in the literature, in which a brain tumor associated with cyst formation verified in a patient of tuberous sclerosis.
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PMID:[Cystic brain tumor associated with tuberous sclerosis -familial occurrence of tuberous sclerosis with normal intelligence- (author's transl)]. 724 95

The symptomatological investigations on 20 cases of cerebellar astocytoma were carried out. These cases, observed and treated in Hokkaido University Hospital from 1959 to 1978, were divided into two groups, such as childhood group (under 15 years old) and adult group (over 16 years old). The following conclusions were obtained: (1) The youngest was 2 years old and the oldest was 64 years old. The age distribution showed higher incidence in younger age group under the age of 30, especially in the first decade. (2) The most frequent symptoms were vomiting, headache and unsteady gait in all cases, but vomiting was constantly seen in childhood cases. (3) The average length of history in children was 2.4 months in childhood, and 17.6 months in adult cases. (4) Neurological signs on admission could be summarized as follows. The signs indicating increased intracranial pressure was most frequent, and the next common findings were ataxia of the limbs and trunk. Impairment of the cranial nerves and brainstem were uncommon. On neurological signs there was little difference between in children and in adults. (5) The total cases of complete removal of the tumor were many, but in adults there were not a few cases in which incomplete removal of the tumor was accomplished. (6) The majority of cerebellar astrocytoma were cystic and laterally placed in the cerebellum especially in children. (7) Microscopically in children, the frequent type was pilocytic astrocytoma of juvenile type. (8) The result of surgical removal of cerebellar astrocytoma was excellent, and the long-term survivours were found frequently and the quality of survival was good. The follow-up results in children were better than those in adults.
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PMID:[A clinical survey of cerebellar astrocytoma--comparison between childhood and adult cases (author's transl)]. 736 Mar 6

A 14-year-old boy with a malignant astrocytoma in the third ventricle, who showed reversible delayed radiation effects on the brain, is presented. One and a half months after the completion of a course of radiation therapy, the patient gradually became drowsy complaining of headaches, general malaise and disturbance of gait. The symptoms and abnormalities in the CT scans were the most severe seven months after irradiation and then spontaneously subsided. CT scan could not differentiate it from a recurrence of the tumor when first seen, but was extremely useful in following these findings.
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PMID:Reversible delayed radiation effect on the brain after radiotherapy of malignant astrocytoma. 741 73

We review 160 cases of gliomatosis cerebri from the literature and report an additional three infants and young children who presented with intractable epilepsy, corticospinal tract deficits, and developmental delay in whom a pathologic diagnosis was made. The progressive nature of the encephalopathy in our cases was documented by serial clinical examination, electroencephalograms, magnetic resonance imaging, and positron emission tomographic scans. The natural history of gliomatosis cerebri was determined by a retrospective review of the literature of 160 cases in 85 reports. The most common neurologic symptoms and signs included corticospinal tract deficits (58%), dementia/mental retardation (44%), headache (39%), seizures (38%), cranioneuropathies (37%), increased intracranial pressure (34%), and spinocerebellar deficits (33%). The most commonly involved central nervous system structures were the centrum semiovale and cerebrum (76%), mesencephalon (52%), pons (52%), thalamus (43%), basal ganglia (34%), and the cerebellum (29%). Fifty-two percent of patients were dead within 12 months of onset. Different grades of glial neoplasm may also coexist within gliomatosis cerebri such as astrocytoma with anaplastic astrocytoma, atypical or anaplastic oligodendroglioma, and glioblastoma multiforme. Hypotheses regarding the pathogenesis of gliomatosis cerebri include blastomatous dysgenesis, diffuse infiltration, multicentric origin, in situ proliferation, and "field transformation." The biologic determinants of whether a transformed glial cell behaves as a relatively localized tumor mass or truly loses anchorage dependence to become migratory as well as proliferative are not understood.
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PMID:Gliomatosis cerebri presenting as intractable epilepsy during early childhood. 753 65

A case of astrocytoma whose first clinical presentation was diagnostic dyspraxia was reported. A 38-year-old right-handed male experienced funny motion of his left hand triggered by voluntary movement of his right hand. One day, he tried to insert a coin into the vending machine with his right hand, then the left hand was against the other. One month after that event, he experienced headache and vertigo. On admission, there were no abnormal findings on neurological examination. On neuropsychological examination, he was cooperative, well orientated and attentive, and there were no callosal disconnection symptoms. Frontal lobe function tests were slightly impaired. T1-weighted MRI demonstrated irregular mixed signal intensity mass lesion extending from the genu to the body of the corpus callosum and the cingulate gyrus. This lesion was slightly enhanced with Gd-DTPA. Biopsy was performed and histological diagnosis was fibrillary astrocytoma. After irradiation and chemotherapy, he was discharged from the hospital without evident neurological deficit. About 20 cases of diagnostic dyspraxia have been reported and almost all of them were caused by cerebro-vascular disease. This is the first case of brain tumor who presented diagnostic dyspraxia.
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PMID:[A case of astrocytoma of corpus callosum presented diagnostic dyspraxia]. 754 21

A 54-year-old female presented with a huge mixed cavernous angioma and astrocytoma in the hypothalamus manifesting as headache, visual field defect, gait disturbance, and convulsion. Radiological studies revealed a huge suprasellar tumor encasing all the major cerebral vessels. Craniotomy disclosed a hemorrhagic tumor poorly demarcated from the surrounding brain which was partially removed. Histological examination of the operative specimen revealed cavernous angioma with low grade glioma in the periphery. The residual tumor responded to radiation therapy remarkably well. An autopsy conducted 3 years later revealed a small hypothalamic astrocytoma with abundant vasculature.
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PMID:Mixed cavernous angioma and glioma (angioglioma) in the hypothalamus--case report. 759 67

Tectal glioma is rare and difficult to diagnose, and the tumor has been known as the tumor that gives no indication of the need for direct surgery because of its anatomical location. At present, MR imaging is available to detect the tumor and its location. We present two patients who underwent direct surgery. Case 1: A 18-year-old female was admitted with headache and nausea. MRI showed signs of stenosis of the aqueduct and a tumor of the tectal region. The tumor was removed partially. Histological examination of this tumor demonstrated a low grade astrocytoma. After surgery, hydrocephalus improved. Case 2: A 12-year-old boy was admitted with hydrocephalus detected by CT. MRI demonstrated a tumor of the midbrain without confirmation. He underwent a V-P shunt for hydrocephalus, and was discharged without any complaints. After 2 years, he was admitted again with shunt malfunction. After shunt revision, his consciousness recovered. However, Parinaud's sign appeared and patency of the shunt was unstable. MRI revealed a tumor of the tectal region and signs of stenosis of the aqueduct of Sylvius. The tumor was removed directly by the occipital transtentorial approach. The aqueduct was opened and a catheter was inserted from the 3rd to the 4th ventricle. Histological examination revealed a low grade astrocytoma. The patient followed a satisfactory postoperative course except for slight Parinaud's sign, and the V-P shunt was no longer necessary.
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PMID:[Two surgical cases of tectal glioma]. 766 42

An unusual case of an intracranial glioma which demonstrated extramedullary growth is reported. The patient was a 39-year-old woman who had experienced headache, nausea and vomiting for about 1 month. On admission she showed slight disturbance of consciousness and bilateral papilloedema. CT scan and MR imaging disclosed a mass approximately 5 cm in diameter in the right frontal region, with clear demarcation from the neighboring gyri. Right external carotid angiogram revealed A-V shunts in the mass, but by right internal carotid angiogram, no abnormal findings were disclosed except for the deviation of normal intracranial vessels due to the existence of the mass. Therefore, a preoperative diagnosis of extramedullary tumor such as meningioma and epidermoid was made. Right frontal craniotomy was performed, and the tumor was proven to exist in subdural space. The boundary of the tumor to the brain surface was distinct except for one part. Histopathologically, the tumor cells had abundant eosinophillic cytoplasms, with eccentric-distribution of their nuclei. Furthermore, they were positive for staining for GFAP and S-100 protein. Therefore, a final diagnosis of gemistocytic astrocytoma was made. Reviewing some references the authors discuss here the form of development and progression of intracranial gliomas which demonstrate extramedullary growth such as this case.
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PMID:[A case of intracranial glioma which demonstrated extramedullary growth]. 781 73

Reported here is a rare case of intracranial foreign body granuloma caused by fine cotton fibers originating from the cotton sheet, which was used in the previous operation. The patient was a 54-year-old woman who presented with headache and right hemiparesis. CT scan demonstrated a large enhanced tumor in the left temporal lobe. During the operation, the tumor bled easily and was hard to remove. The brain surface was covered with oxidized cellulose (Oxycell) after the tumor was subtotally removed. Cotton sheets (Surgical Patty) were also used during the operation. The microfibrillar collagen hemostat (Avitene) was not applied. The histological diagnosis was astrocytoma. Radio-chemotherapy was given. CT and MRI on the 40th day after the operation, showed a large tumor in the left temporal lobe, which led to suspicions of tumor recurrence. The second operation disclosed a mass which was harder in consistence than the previous one. The histological diagnosis was foreign body granuloma, which contained a lot of fine cotton fibers. Oxycell was not found in it. The cotton-sheet is well documented as a cause of granuloma in the literature, but it is seldom mentioned that the foreign body granuloma is caused by cotton fibers, scattered in the operative fields. This case report suggests the possibility of cotton-fiber granuloma and our simple experiment indicated that a lot of cotton fiber might be scattered in the operative fields, if dry cotton sheets are used. These results stress that washed cotton sheets should be applied to avoid the possibility of the development of cotton-fiber foreign body granuloma.
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PMID:[Intracranial foreign body granuloma caused by fine cotton fibers: a case report]. 781 82


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