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 report is given on 113 tumours of the 4th ventricle in children (up to the age of 18 years) observed among a total of 1028 cerebellar operations. Of these, 87 (= 77%) tumours were exclusively tumours of the 4th ventricle, in 26 cases the tumour also encroached on adjacent structures (cerebellar hemisphere and vermis, pons and Medulla oblongata). Medulloblastomas were predominant (55%), they mainly occurred in school age. Leading clinical symptom of the tumours of the 4th ventricle - especially in child age - is the increase in intracranial pressure which can often be demonstrated radiologically in this age group. Besides there are coordination disturbances and disturbances of the cerebral nerves; relatively frequently one sees a "vermis syndrome". The initial symptoms, which are in most cases non-characteristic (nausea, headache, also ataxia), are more often than not misinterpreted. Surgically treatment aims at a radical removal of the tumour whenever of possible, which is frequently problematic in children, and the restoration of the pathways the cerebrospinal fluid. Microsurgical techniques clearly contributed to a decrease in the mortality rate which, however, still is very high. This stresses the importance of an improvement of early recognition of these tumours.
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PMID:[Special diagnostic and surgical problems in tumors of the 4th ventricle in childhood]. 663 59

Medulla oblongata teratomas are rare. The authors report 2 new cases of teratomas that occurred exclusively in the medulla oblongata. The first case was in a 9-year-old boy who presented with a 6-month history of neck pain and repeated paroxysmal vomiting. Based on preoperative radiographic findings, the initial diagnosis was of an intraaxial medulla oblongata hemangioblastoma. Intraoperatively, the cystic component of the tumor was gray, gelatinous, and soft in consistency. The solid component was light pink, rubbery, and nodular in appearance, with an identifiable boundary. The lesion was completely removed. Histopathological investigation revealed a mature teratoma. Postoperatively, the patient was supported with ventilator assistance and received a tracheotomy, but died of intracranial infection. The second case was in a 10-year-old boy with intermittent headache for 1 month. Radiographs revealed an exophytic cystic and solid lesion with dorsal involvement of the medulla oblongata. The lesion was predominantly solid, pinkish gray, tenacious, and moderately vascularized, with clearly delineated surgical dissection planes. The histopathological examination confirmed a diagnosis of immature teratoma. Total resection was achieved, followed by postoperative chemotherapy. He was alive without recurrence of the lesion or symptoms at 59 months after surgery. Resection of medulla oblongata teratoma is challenging, with inherent surgical risks that are contingent on the tumor growth pattern. Teratomas should be considered in the differential diagnosis of brainstem lesions. Chemotherapy has been suggested for immature teratomas. Long-term follow-up and larger studies of teratomas in unusual locations are required to improve practitioners' understanding of this disease's treatment and outcomes.
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PMID:Primary medulla oblongata teratomas. 2499 19