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)

Stenosis of the intracranial internal carotid artery by other tumors than meningiomas and pituitary adenomas is a rare occurrence. We present here a case with craniopharyngioma, which developed severe stenosis of the intracranial internal carotid artery 7 years following partial removal and irradiation. This severe stenosis of the intracranial internal carotid artery would result from combination of compression of the arterial walls against the surrounding bony structures and radiation effect on the arterial walls. A 29-year-old male was found to have a craniopharyngioma, which was treated by partial removal in 1971. He had suffered bilateral optic atrophy, right homonymous hemianopsia and panhypopituitarism. Angiography revealed elevation of the A-1 and opening of the carotid siphon on both sides. He had a course of 5,000 rads of Lineac irradiation in 1972. He showed no clinical improvement. He became totally blind in 1976. He was admitted again in 1979, because of left sided weakness and Korsakoff syndrome. Examination disclosed that there were bilateral optic atrophy, left hemiplegia with hyperreflexia and pathological reflexes, hypesthesia in the left side of the face and Korsakoff syndrome, chiefly consisting of confabulation. Angiography showed that the right internal carotid artery was markedly elevated and stenosed. The left internal carotid artery was elevated and the left A-1 was stenotic. The territory of the left distal anterior cerebral artery was filled from the anterior falx artery of the ophthalmic artery. The right A-1, M-1 and M-2 were filled through the left A-1. The territory of the right anterior cerebral artery was filled through the right posterior pericallosal artery and that of the right middle cerebral artery was partly filled through the posterior temporal and occipito-parietal arteries of the posterior cerebral artery. A right superficial temporal-middle cerebral artery bypass surgery was performed with some clinical improvement.
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PMID:[Stenosis of the intracranial internal carotid artery by a craniopharyngioma: report of a case]. 713 1

Craniopharyngioma, often with cystic diliatation, is difficult to resect radically. Fifty patients with huge craniopharyngioma (diameter of tumor was over 5 cm) treated with intratumoral irradiation of radioactive isotopes (32P and 90Y) through CT-guided Leksell stereotactic system are reported. The patients were 2 to 69 years of age with the disease of 1- to 12-year duration. Of the 50 patients, 21 had recurrent tumor after craniotomy, 29 without surgery operation before. All tumors were confirmed pathologically. The major clinical symptoms were as follows: visual field defect, headache, vomiting, diabetes insipidus, hemiplegia and growth retardation in juvenile cases. There was no death or serious complications following the treatment procedure. Partial response (> 50% reduction of tumor size on CT scanning with improvement of symptoms and signs) rate of the treatment was 82.0% at one month and 62.0% at 2 to 7 years after treatment.
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PMID:[Stereotactic intratumoral irradiation of huge craniopharyngioma]. 938 64

Craniopharyngioma management is challenging. Although histology is benign, the tumour can be clinically aggressive with local invasion and frequent recurrences. Extensive morbidity may be present at diagnosis and furthermore, occurs as a consequence of neurosurgery and radiotherapy. Hypothalamic symptoms can have a devastating effect on quality of life and may reduce life expectancy. This case highlights both the challenge of managing hyperphagia and morbid obesity and the importance of initial treatment preserving existing hypothalamic function and the need to avoid tumour recurrence and further surgery. A 11-year old boy presented with hydrocephalus secondary to a craniopharyngioma (he had visual failure and hypopituitarism but few hypothalamic symptoms). He underwent radical resection followed by radiotherapy. Following this treatment, he developed psychological and behavioural problems and hyperphagia. Weight gain in the first year (an increase from +1.4 to +3.7 s.d.) resulted in poor mobility and a fall which caused a slipped femoral epiphysis. In the next year, there was a 6-month period of unexpected weight loss (+4.2 to +3.8 s.d.) that culminated in emergency treatment for diabetic ketoacidosis secondary to severe insulin resistance. He developed a left hemiplegia, and a subsequent cerebral angiogram identified multiple stenoses of the Circle of Willis with a Moyamoya appearance secondary to radiotherapy. Weight gain has continued (+3.8 to +5.5 s.d.) so that bariatric surgery is a management option.
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PMID:'Do no harm': management of craniopharyngioma. 1877 78