Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Low-grade astrocytomas comprise a group of primary brain neoplasms with relatively low anaplastic potential, although through time they tend to behave more aggressively. They have a very heterogeneous natural course and clinical behavior. This report presents a natural history of a patient with low grade astrocytoma. A 32-year-old male sustained head injury after grand mal seizure. On admission, he was conscious and without neurological deficit. Initial computerized tomography and magnetic resonance of brain revealed oval, 4 cm in diameter, lesion in the left parietal region that was considered as low-grade glioma. The patient refused surgery. Eight years and four months later, he was readmitted. This time, he was subcomatose with right hemiplegia. Repeated computerized tomography showed huge tumor in the left frontoparietal region at the site of previous lesion. Urgent left frontoparietal craniotomy and reduction of tumor were performed. The patient recovered after surgery. Right hemiparesis remained. The described patient with low-grade astrocytoma lived without any oncological treatment eight years and four months from the time when diagnosis was made until intracranial herniation. The natural history of disease in presented patient indicated that rational therapeutic strategy, for low-grade astrocytoma with epilepsy only, would be deferral of surgery until the time of manifestation of neurological or radiological deterioration.
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PMID:[Natural history of supratentorial low-grade astrocytoma: case report]. 1730 70

Brainstem glioma usually carries a poor prognosis and prolonged survival is very infrequent. In a detailed Pubmed, Medline search for prolonged survival, authors could got a longest survival only up to seventeen years, reported by Umehara et al, who was subjected to gamma knife therapy and got symptomatic, MRI brain reveled large tumor growth during pregnancy necessitating emergency surgery and histopathological diagnosis was pilocytic astrocytoma. Authors report an interesting case of midbrain glioma diagnosed 21 years back, who underwent gross resection in the year 1993, histopathology was pilocytic astrocytoma, WHO grade I, and received gamma knife surgery for residual subsequently and he presented with sudden onset left sided hemiplegia on the current admission. The cranial MRI imaging revealed an infarct involving right hemi midbrain, contrast MRI brain revealed no residual glioma. To the best knowledge of authors such prolonged survival is not reported with a case of brainstem glioma survived twenty- one years with non residual tumor on the last imaging study represents first case of its kind in the western literature and probably developed hemiplegia due to bleed, highlighting bleed as delayed complication following gamma knife therapy for cranial tumors.
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PMID:Pilocytic Midbrain Astrocytoma Presenting with Fresh Bleed after Twenty-one-years Survival Following First Surgery: A Unique Case of Longest Brainstem Glioma Survival. 2816 14