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

We reported a case of a patient who suffered from a cerebrovasculopathy after irradiation therapy for astrocytoma located at the left temporal lobe. An eleven year-old boy who presented himself with headache and vomiting as his chief complaints received partial removal of a tumor. Histological diagnosis of the tumor was astrocytoma (grade II). His preoperative cerebral angiograms showed mass sign solely, without stenosis or occlusion of the cerebral vessel. Postoperatively, he was treated with irradiation therapy involving the whole brain with a total of 30 Gy, and gamma knife therapy. Six months after irradiation, he started suffering from frequent cerebral ischemic attacks, but there was no regrowth of the tumor visible on CT scans. Cerebral angiograms were made again, and revealed multifocal stenoses in the bilateral internal carotid arteries, middle cerebral arteries, and the anterior cerebral artery. His symptoms did not improve after conservative treatment with steroids, calcium antagonist, or low molecular weight dextran. Although he received a superficial temporal artery-middle cerebral artery (STA-MCA) anastomoses bilaterally, multiple cerebral infarctions appeared. Although irradiation therapy is acceptable in patients with brain tumor, a cerebrovasculopathy after irradiation should be considered as one of the most important complications, and the risk incurred by irradiation therapy should lead to more careful consideration and caution when treating intracranial brain tumors, especially in children. From our experience, the usefulness of bypass surgery for radiation-induced cerebrovasculopathy is still controversial.
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PMID:[Radiation-induced cerebrovasculopathy: a case report and review of the literature]. 836 76

A case of cerebellar pilocytic astrocytoma is reported. This tumor occurs typically in the first two decades of life and is seldom reported in adults. The 42-year-old patient presented with occipital headaches, nausea, and unsteady gait. Nystagmus and right dysmetria were noted. A CT scan showed a hypodense, nonenhancing, voluminous, right hemispheric cerebellar cyst. Magnetic resonance imaging showed a nodule in the wall of the cyst which became hyperintense with gadolinium. The mass was resected through a small occipital craniotomy. Neuropathological examination revealed a juvenile pilocytic astrocytoma.
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PMID:Pilocytic cerebellar astrocytoma in adults: case report. 849 94

The clinical, neuroradiologic, and pathologic features of an unusual retinal and cerebral giant cell astrocytoma in a 24-year-old man with tuberous sclerosis are reported. The patient was referred at 3 years of age because of partial seizures from the first months of life, severe mental retardation, and left microphthalmos. The microphthalmic eye presented slow growth from 9 years of age and was enucleated at age 18 years because of exophthalmos and pain. At age 23 years, the patient experienced sudden and severe headache. Magnetic resonance imaging revealed a voluminous cystic tumor in the region of the foramen of Monro, lateral ventricle, and basal ganglia of the right cerebral hemisphere. Pathologic examination of the enucleated eye and of the cerebral tumor disclosed the same histologic findings in both locations, a giant cell astrocytoma.
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PMID:Tuberous sclerosis associated with histologically confirmed ocular and cerebral tumors. 853 86

Between July 1992 and August 1995, 11 patients with pineal region tumors (PRTs) were treated at our center. Ages ranged from 8 to 72 years (median 21). Diagnosis was confirmed by histological examination in 7 patients. The remaining cases had strong neuroradiological and marker evidence of the diagnosis, so that a stereotactic biopsy could be avoided. The pathological diagnoses were pinealocytoma (n = 1), tectal astrocytoma (n = 1), germinoma (n = 2), pinealoblastoma (n = 2), and meningioma (n = 3). The marginal dose of these tumors ranged from 12 to 18-20 Gy. Conventional external radiotherapy was never used in this series. With a median follow-up of 12.3 months (range 2-34), all tumors responded to treatment and disappeared or ceased growing. We observed no mortality or major morbidity. One patient (tectal astrocytoma) had a mild radiation-induced reaction, with headache and transient worsening of an abducent nerve palsy, which were controlled with steroids. In germinomas and pinealoblastomas, recovery of normal cerebrospinal fluid circulation was observed in less than 7 days, in parallel with major tumor shrinkage. In this study we confirm that radiosurgery can be an effective and safe alternative for the treatment of pinealocytomas and low-grade tectal gliomas. Moreover, we consider that the characteristics of the radiosurgery technique suggest the method should be evaluated for the treatment of malignant PRTs.
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PMID:Pineal region tumors: the role of stereotactic radiosurgery. 903 58

The effect of radiosurgery on optic gliomas is uncertain. We report two cases of low-grade glioma of the optic nerve and chiasm treated by transcranial subtotal removal and Gamma Knife radiosurgery. The first case was a 2-year-old boy, admitted with visual disturbance and nystagmus. Histopathological examination showed a pilocytic astrocytoma. The tumor volume was 14.4 cm3. Dose planning was performed using axial and coronal T1-weighted enhanced images. The marginal dose was 12 Gy at the 40% isodose line. The dose to the optic apparatus was less than 9 Gy. The second case was a 47-year-old woman, admitted to our hospital with headache and visual disturbance. The histopathological findings showed a fibrillary astrocytoma. The tumor volume was 12.3 cm3. The marginal dose was 14.4 Gy at the 40% isodose curve. The follow-up periods for the two cases were 24 and 43 months, respectively. In both cases the most recent follow-up magnetic resonance scan showed a marked decrease in tumor size, and visual symptoms were improved. No postradiosurgical complications have developed to date. Gamma Knife radiosurgery could be an effective adjuvant therapy for low-grade optic glioma. However, long-term follow-up is required for further evaluation of the efficacy and potential side effects.
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PMID:Two cases of Gamma Knife radiosurgery for low-grade optic chiasm glioma. 903 59

Two cases of astrocytoma associated with von Recklinghausen's disease (neurofibromatosis type; NF-1) were reported. The first case wes a 60-year-old man who had been diagnosed as von Recklinghausen's disease on the basis of skin findings. Magnetic resonance imaging (MRI) showed a tumor in the left temporal lobe. Partial removal was performed with neuronavigator, and because of the existence of Rosenthal fiber the histological diagnosis was pilocytic astrocytoma. Radiation therapy was performed. The second case was a 6-year-old boy suffering from headache and left hemiparesis including his face. MRI showed a tumor with a cyst in the right thalamus and obstructive hydrocephalus. Initially CT-guided stereotactic biopsy was performed, and the histological diagnosis, on the basis of increased cellularity, pleomorphism and nuclear atypia without necrosis or vascular proliferation, was anaplastic astrocytoma. Radiation and chemo-immuno therapy were carried out after V-P shunt. It is well known that von Recklinghausen's disease (NF-1) is often associated with optic glioma (5-36%). In the literature, the glioma seldom occurs in other parts of the brain, supratentorial glioma especially is rare. Only two familial cases of supratentorial glioma associated with von Recklinghausen's disease have been reported. The prognosis of supratentorial glioma associated with NF-1 was poor in these reports. In this paper, the diagnostic and therapeutic problems are discussed.
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PMID:[Familial astrocytoma associated with von Recklinghausen's disease: report of two cases]. 905 38

From 1980 to 1994, 59 patients with a diagnosis of lowgrade astrocytoma were treated in our hospital. We analyzed survival, prognostic factors and quality of life (QOL) in survivors who had been recurrence free for at least 2 years. The overall 2-, 5- and 10-year survival rates were 75, 65 and 49 % respectively. The major prognostic factors were field size (the smaller, the better) and age (the younger, the better) according to Cox regression analysis. Quality of life was evaluated in the 20 patients who had survived at least 2 years without tumor regrowth. Performance status was good in most of the patients, and 17(85%) patients were intellectually and physically normal. Headache, fatigue and memory difficulties were the major clinical complaints of these patients and were observed in 7(35%), 6(30%) and 7(35%) of the patients, respectively, although severe symptoms were rare.
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PMID:[Radiation therapy for low-grade astrocytomas: survival and QOL]. 919 64

A 26-year-old woman was admitted to our hospital because of headache. CT scan and MRI showed a right subependymal nodule and a left ventricular tumor, neither of which had any enhancement nor were they stained in angiography. Although no skin abnormality was detected, the patient was suspected of tuberous sclerosis. The diagnosis was made because of the subependymal nodule on CT scan and MRI. On June 29, 1995, total removal of a left ventricular tumor was performed by a transcortical approach. Histological sections of this tumor consisted of astrocytic and meningothelial components, containing metaplastic bone formation. Histological diagnosis was dysplastic subependymal tumor. Postoperative course was uneventful. Regrowth of the tumor has not been observed as of now. This case was suspected to involve factors of tuberous sclerosis from a subependymal nodule. However, the ventricular tumor was not diagnosed as a subependymal giant cell astrocytoma.
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PMID:[Subependymal tumor with metaplastic bone formation: a case report]. 933 Apr

We presented a case of tuberous sclerosis (TS) associated with subependymal giant cell astrocytoma (SEGC) and renal angiomyolipoma (RAML). A 19-year-old female, who had been diagnosed as TS since she was 3 months old, was admitted with complaints of headache, vomiting, and abdominal pain. At 10 years of age, a ventricular tumor was shown on CT, and at 16 years of age a ventricular peritoneal shunt was placed for obstructive hydrocephalus. On admission, an abdominal CT showed bilateral renal huge multicystic tumors with hemorrhage, which were diagnosed as RAMLs. CT and MRI showed an intraventricular tumor near the foramen of Monro, and this tumor was removed through a transcortical approach. The pathological diagnosis was SEGA. Large sized RAMLs were identified by CT. Although TS is often associated with additional tumors in the brain, heart, kidney, and other organs, the combination of SEGA and RAML is quite rare. If ventricular peritoneal shunt is placed in a TS patient, risk of shunt malfunction should be taken into account.
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PMID:[Tuberous sclerosis associated with subependymal giant cell astrocytoma and renal angiomyolipoma: a case report]. 938 66

A 45-year-old male presented with sudden onset of severe headache. Computed tomography and magnetic resonance imaging demonstrated an irregularly enhanced suprasellar mass with intratumoral and subarachnoid hemorrhage. The mass was removed in two operations. Histological examination of the tumor revealed pilocytic astrocytoma. The relatively rich vascularity and perivascular tumor cell proliferation observed in this benign lesion were probably the causes of this extremely rare association.
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PMID:Hypothalamic pilocytic astrocytoma presenting with intratumoral and subarachnoid hemorrhage. 941 29


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