Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 13-year-old boy presented to the emergency room with headaches and ataxia. Imaging studies revealed a cerebellar hemorrhage within a posterior fossa tumor. The patient underwent complete resection of this lesion and made a full recovery. Microscopic examination of this lesion revealed a juvenile pilocytic astrocytoma.
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PMID:Spontaneous cerebellar hemorrhage due to a juvenile pilocytic astrocytoma: case report and review of the literature. 1142 72

Pilocytic astrocytomas are usually present as solitary posterior cranial fossa tumours. An unusual case of pilocytic astrocytoma in a 3 year and 8 month old boy is presented. The patient presented over the course of 10 months with intermittent headaches, vomiting, gait ataxia and drowsiness. After extensive investigations magnetic resonance imaging (MRI) revealed widespread lesions throughout the central nervous system, including multiple cystic cerebral grey matter lesions. A brain biopsy was performed and pathological studies revealed pilocytic astrocytoma. The literature pertaining to neuraxis dissemination of pilocytic astrocytomas in the paediatric population is reviewed. There are only a very limited number of reports of pilocytic astrocytoma ca using multiple brain lesions, with no publications of multiple cystic brain lesions. We believe this to be a unique case of pilocytic astrocytoma presenting with widespread cystic lesions throughout the brain.
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PMID:Multiple cystic brain lesions in a patient with pilocytic astrocytoma. 1143 82

Glioma is one of the most common brain tumors but the outcome of treatment is still uncertain. The author conducted this study to find the prognostic factors affecting the outcome. The medical records of 41 patients, diagnosed as having glioma, admitted to the Neurosurgery Division, Prasat Neurological Hospital, between January 1998 and December 1999 were retrospectively reviewed. Gender, age, history of smoking and alcohol drinking, symptoms and signs, CT and MRI findings, underlying pathology, locations of lesions, treatments and outcomes were analysed. There were 20 males and 21 females with ages ranging from 2 to 75 years. The mean age was 39.78 +/- 19.81 years old. The three most common presenting symptoms were headache, motor weakness, and seizures. The predominant location of the tumors was in the cerebral hemisphere. Most low grade astrocytoma show low/iso-density with slight contrast enhanced in CT scan. The patients were divided into two groups according to the outcome, improved and dead. Gender, age, history of smoking and alcohol drinking, location of tumors did not have any effect on the outcome. The factors affecting the outcome of treatment were histological subtypes and types of treatment. There was a statistically significantly better outcome in low grade astrocytoma and tumor removal with irradiation. The overall mortality was 21.95 per cent after two years.
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PMID:Glioma of the central nervous system: factors affecting the outcome. 1146 Sep 45

(1) Temozolomide, a cytotoxic agent, was recently licensed in France for treating patients with anaplastic astrocytoma who are in relapse or progression after standard therapy. (2) The clinical dossier contains only one non comparative trial. (3) In this trial, 111 patients with anaplastic astrocytoma or oligoanaplastic astrocytoma had not all had the standard treatment with surgery, radiotherapy and chemotherapy based on nitrosourea plus procarbazine. In the subgroup of 54 patients who met these criteria, median global survival on temozolomide was 16 months, or 31 months from the start of initial treatment, which was no better than survival before the introduction of temozolomide. (4) The adverse effects of temozolomide include gastrointestinal disorders (nausea, vomiting, constipation), headache, and haematological disorders.
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PMID:Temozolomide and anaplastic astrocytoma: new indication. No clear proof of efficacy. 1147 93

Gliomatosis cerebri is considered grade III astrocytoma because of the short survival period of patients with this tumor, while the tumor histologically consists of widespread low grade astrocytoma cells. The authors tried to clarify this discrepancy by applying genetic analysis of the tumor. A 29-year-old man originally presented with mild headache and showed diffuse high intensity areas in both hemispheres and in the cerebellum by T2-weighted magnetic resonance imaging (MRI) without gadolinium-dimeglumine (Gd)-enhancement in T1-weighted imaging. Histological diagnosis was gliomatosis cerebri with diffuse grade II astrocytoma. Seven months after temporary improvement following irradiation and chemotherapy, he developed progressive mental deterioration, and died in one year after the surgery. At this time T1-weighted imaging showed Gd-enhanced lesions with enlargement only of the cerebellar tumor. Genetic analysis demonstrated positive FGFR 1 and less FGFR 2 mRNA in the tumor tissue, and FGFR 1 mRNA was beta type dominant. These results indicated that the genetic features of this tumor are similar to those of glioblastoma multiforme concerning FGFR expression. The authors conclude that genetic investigation of the tumor tissue is required to predict the prognosis of gliomatosis cerebri patients, in addition to imaging and histological examinations.
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PMID:Histological and genetic diagnosis of gliomatosis cerebri: case report. 1151 53

Retrospective analysis of 27 patients of thalamic glioma including adults and children treated over a period of 7 years from 1991-1997 was done. The study group included 19 males and 8 females; 9 patients were less than 15 years and 18 patients more than 15 years of age at the time of diagnosis. The commonest symptoms were headache and vomiting. 12 patients underwent VP shunt as an initial procedure and 7 underwent total or partial surgical resection. Confirmed histopathological examination was possible in 16 patients; while 12 had low grade astrocytoma, 4 cases had high grade histology. All patients were treated with radiotherapy to a total dose of 50-60 Gy in 25-30 fractions. Median follow up was 9.63 months. The disease free survival in these patients was 28% at 2 years. Prognostic factors which included age, sex, duration of symptoms, surgical procedures, histology and radiotherapy dose were evaluated for significance. A subtotal resection conferred a better prognosis.
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PMID:Prognostic factors influencing the outcome of thalamic glioma. 1196 Jan 49

Eleven cases of a distinctive tumor of the posterior fossa are described. The patients (age range 12-59 years) presented with headache and/or ataxia. Neuroimaging revealed a relatively discrete, focally enhancing mass(es) primarily involving the aqueduct, fourth ventricle, and cerebellar vermis. Hydrocephalus was present in seven cases, and two lesions were multicentric. In two cases a significant increase in tumor size was documented. Gross total or subtotal resections were achieved in 10 cases. One patient underwent biopsy alone and another received postoperative irradiation. Histologically, two components were identified in all cases. One consisted of neurocytes forming neurocytic and/or perivascular pseudorosettes in a fibrillary, partly microcystic matrix. The second, astrocytic component resembled pilocytic astrocytoma in 10 cases and consisted of fibrillated spindle cells with oval nuclei associated with occasional Rosenthal fibers, granular bodies, glomeruloid capillaries, and microcalcifications. Regionally, this component was more diffuse and patternless, consisting of sheets of round to oval, oligodendrocyte-like cells. Rare ganglion cells were seen in four cases. The rosettes were consistently synaptophysin and MAP-2 immunoreactive, whereas the spindle cells were positive for S-100 protein and glial fibrillary acidic protein. Overall, atypia was minimal; no mitoses were found, and Ki67 labeling indices were low. Ultrastructurally, the neurocytic cells featured processes containing microtubules and occasional dense core granules. Mature synapses were found in one of the four cases studied. Although the histologic features of this unique tumor superficially resemble those of dysembryoplastic neuroepithelial tumor, rosette formation by neuronal cells, the frequent presence of a pilocytic astrocytoma component, and the growing nature of the lesion argue against that diagnosis, as does occasional multifocality.
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PMID:A rosette-forming glioneuronal tumor of the fourth ventricle: infratentorial form of dysembryoplastic neuroepithelial tumor? 1197 88

Gangliogliomas represent approximately 0.2% of all the intracranial tumors. Ganglioglioma arising from the cerebellum is rare, with a rate of 1.5-9% of CNS gangliogliomas. The authors report a case of cerebellar ganglioglioma with a huge cyst. A 28-year-old man presented headache and ataxia. Computerized tomography (CT) demonstrated a huge cyst at the vermian region with calcification located at the peripheral side of the cyst. Magnetic resonance imaging (MRI) with administration of Gd-DTPA showed a slightly enhanced small mass at the left side of the cyst. Preoperative diagnosis of the lesion seemed to be a cystic astrocytoma. The tumor was removed subtotally through the midline suboccipital approach. Pathological examination of the tumor specimen revealed a ganglioglioma. The postoperative course was uneventful with no sign of tumor regrowth on repeated MRI. According to the previous 17 reports of cerebellar ganglioglioma including our case, the shorter interval from onset to the diagnosis and clinical symptoms such as increased intracranial pressure were conspicuous as compared with supratentorial ganglioglioma because of the anatomically narrow space of the posterior fossa. Neuroradiological findings showed tumor enhancement in 86% of the cases, calcification in 67%, and cyst formation in 53%.
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PMID:[Cerebellar ganglioglioma associated with a huge cyst: case report]. 1199 73

Granular cell astrocytomas (GCAs) are rare, incompletely characterized infiltrative gliomas that contain a prominent component of granular cells. Such tumors can readily be mistaken for reactive conditions. We studied 22 cases to explore their morphologic spectrum, establish features useful in distinguishing GCA from nonneoplastic diseases, and to determine which parameters correlate with biologic behavior. Tumors occurred in 17 men and five women, ranging in age from 29 to 75 years, who presented mainly with seizures, headache, aphasia, or hemiparesis. Radiologically, high-grade GCAs were contrast-enhancing, cerebral hemispheric masses with prominent peritumoral edema. All contained sheets or interspersed large, round cells packed with eosinophilic, PAS-positive granules. Lymphocytic infiltrates, either perivascular or admixed with neoplastic cells, were present in 14 tumors. Transition to typical infiltrating astrocytoma was noted in 16 cases; of these, granular cells comprised 30-95% of cells. Six tumors consisted almost entirely of atypical granular cells. By WHO criteria, four GCA were grade 2, seven were grade 3, and 11 were grade 4. Glial fibrillary acidic protein staining was seen in all but one tumor, and the majority were immunoreactive for S-100 protein, KP-1, ubiquitin, and epithelial membrane antigen. Although MIB-1 proliferation indices increased with tumor grade, granular cells accounted for only a minority of immunoreactive cells. Among 18 cases with follow-up, 15 recurred after surgery and resulted in death (mean survival, 7.6 months). Two patients died postoperatively, and one was alive at 51 months. Granular cell astrocytoma is an uncommon morphologic variant that appears to be rapidly progressive and usually fatal.
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PMID:Infiltrative astrocytomas with granular cell features (granular cell astrocytomas): a study of histopathologic features, grading, and outcome. 1202 79

We report on two children with bilateral thalamic astrocytomas. The first patient developed psychomotor regression at the age of 20 months followed by rapidly progressive ataxia, intention tremor, slurred speech, and bouts of drowsiness. Magnetic resonance imaging (MRI) of the brain showed swelling and high signal intensity in both thalami accompanied by supratentorial hydrocephalus. The second patient presented with progressive cerebellar ataxia, headache, and vomiting at the age of 11 years. MRI of the brain revealed symmetrical, hyperintense and sharply delineated swelling of both thalami. Additional lesions were seen in the cerebellum and the right temporal lobe. In both cases proton magnetic resonance spectroscopy (MRS) of the lesions showed a striking decrease of the neuronal marker N-acetylaspartate, an increase of choline-containing compounds, and a minimal lactate peak. Stereotactic biopsies from the thalamus of the first patient and from a cerebellar lesion of the second patient finally revealed glial tumors, namely a diffuse astrocytoma of World Health Organization (WHO) grade II in the first patient and an anaplastic astrocytoma of WHO grade III in the second patient. We conclude that the clinical manifestations and MRI patterns of bilateral thalamic astrocytomas are very similar to those of encephalitis and neurometabolic disorders and should therefore be included in the differential diagnosis of these encephalopathies.
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PMID:Diagnostic difficulties in childhood bilateral thalamic astrocytomas. 1257 91


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