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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of acoustic neurinoma with parkinsonism and dementia are reported. The characteristics of parkinsonism seen in these cases consisted of the rapid development of symptoms and symmetrical rigidity. In all cases there was a marked enlargement of the ventricular system and transient improvement in their mental states was observed following ventriculoperitoneal shunt or removal of the tumor. In an autopsy case there were no pathological findings in the cerebral cortex, basal ganglia, substantia nigra or pontine nuclei. It was concluded that parkinsonism and dementia in these patients were caused by chronic hydrocephalus due to the acoustic neurinomas.
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PMID:Parkinsonism and dementia with acoustic neurinomas. Report of three cases. 7 63

An overview of brain metastasis with respect to the pathological, diagnostic, and therapeutic aspects is presented. Management is almost always palliative, with cure being a rare exception. Evaluation of various therapeutic modalities--radiation, chemotherapy, or surgery--has been confounded by a lack of controlled, randomized studies whereby the relative benefit of the respective modalities can be assessed objectively. Despite these limitations, some progress is being made in the identification of those patients for whom therapy is likely to be of benefit. Apart from the use of steroids to control cerebral edema, radiotherapy is currently the most commonly employed therapeutic modality for cerebral metastasis. It is the treatment of choice for multiple intracranial metastases and it affords temporary improvement in neurological symptoms in about 60% of patients. For solitary metastases, combined therapy--surgical excision followed by whole brain radiotherapy--has been shown to result in a better quality and longer duration of survival than either modality alone. Except for patients who are terminally ill, aggressive treatment seems warranted, inasmuch as therapeutic results have been improving steadily over the years. Neither chemotherapy nor immunotherapy has been shown to be of benefit in the management of cerebral metastasis. An exception is choriocarcinoma, which responds well to a combination of radiation therapy and chemotherapy. Although the prognosis for meningeal carcinomatosis is poor, improved survival may be achieved by a combination of chemotherapy and radiotherapy. These are recommended guidelines for surgical intervention, usually followed by radiotherapy: (a) In general, surgical excision is recommended only for patients with relatively superficial, solitary lesions. It is reasonable, however, to consider the excision of a metastatic lesion that is immediately life-threatening or incapacitating, even though one or more other metastatic brain lesions may be present. This may be extended to the removal of multiple metastatic brain tumors if they are surgically accessible. (b) The second consideration is whether the primary tumor can or has been treated or if the primary tumor will permit reasonably long survival. (c) There should not be metastases elsewhere in the body, although their presence should not categorically exclude the patient as a surgical candidate. (d) The patient's general condition should be satisfactory. (e) Operation is recommended if the diagnosis of the intracranial lesion is uncertain. (f) A shunt should be considered for treatment of hydrocephalus secondary to obstruction of the cerebrospinal fluid pathway by tumor or edema. (Neurosurgery, 5: 617--631, 1979).
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PMID:Brain metastasis: current status and recommended guidelines for management. 9 55

Among 319 patients under the age of three years with tumors of the brain verified by means of contrast X-ray examination, during operation, or on autopsy, 215 had undergone surgery (166 with tumor of the posterior cranial fossa and 84 with tumor of supratentotial localization). From analysis of 176 cases in which X-ray contrast methods of examination were applied it was established that the method is safe and yields sufficient information for making the topic diagnosis of the tumor, determining its blood supply, its relation to the system of the cerebrospinal fluid and for judging the degree of the concomitant internal hydrocephalus and occlusion of the cerebrospinal fluid passages. In addition, these methods help to solve problems of the techniques of surgical intervention or the contraindications for operations. Analysis of the results of 250 operations shows that when the child's condition and the localization of the tumor permit, the surgeon should strive to perform single-stage subtotal or total removal of the tumor because this does not increase postoperative mortality.
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PMID:[X-ray diagnosis and surgical treatment of brain tumors in young children]. 9 57

Between August 1973 and April 1974 more than 750 patients had computerized axial tomography (CT) scans at the Massachusetts General Hospital. Ten brains from previously CT-scanned patients in this group were sectioned in the plane of the scan. Nearly exact correlation was found between the anatomic location and extent of intracranial lesions demonstrated by CT scan and the findings on gross and microscopic pathologic examination in cases of primary intracranial tumors, obstructive hydrocephalus, intracerebral hemorrhage, ischemic and hemorrhagic infarctions, pineal tumor, and thermal-burn encephalopathy. Determination of absorption values (mu) of 47 pathologically verified processes showed that high-absorption intracerebral hemorrhage and calcium-containing tumors are readily separable from other processes on the basis of mu values alone. However, the abnormal mu values of primary brain tumor, edema, and infarction are difficult to distinguish from those of normal spinal fluid and white matter.
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PMID:Computerized axial tomography: clinicopathologic correlation. 16 48

Fifteen patients with cancer involving the temporal bone have been considered for radical surgical treatment by partial resection of the temporal bone during the past 12 years. All but one had undergone previous treatment by local surgery and/or irradiation. Two patients proved to be inoperable at surgical exploration. Three types of partial resection of the temporal bone and described to encompass disease involving the concha, the mastoid and squamous areas of the temporal bone, the ear canal, the middle ear, and the parotid gland. Closure of the surgical defect has been achieved in five cases using the residual pinna, in four cases with scalp flaps, and in five cases with a deltopectoral flap. Complications have been surprisingly few, with only one postoperative death. In one case communicating hydrocephalus persisted until death from residual disease many months later. Minor repair failure occurred in two patients. No attempt has been made to restore facial nerve function by grafting procedures. Long-term survival has been disappointing; however, it is considered that such radical surgery remains justified in selected cases for relief of the pain and disfigurement caused by chronic ulcerating neoplastic disease.
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PMID:Temporal bone resection for cancer. 29 6

A family is reported in which eight members of one generation were affected by the syndrome hydrocephalus with aqueductal stenosis. With the exception of one child who lived for several weeks, they all died at or within 10 days of birth. Autopsy of a pair of affected twins showed marked stenosis of the aqueduct of Sylvius with fusion of the lamina quadrigemina. There were no signs of previous or present inflammatory changes or neoplasia. All the affected individuals were males, and the familial and pathological data presented support the concept that aqueductal stenosis in this family was due to an X-linked gene, and may have a developmental origin.
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PMID:X-linked aqueductal stenosis. 30 2

The suboccipital craniectomy done with the patient in the prone position using modern microsurgical methods gives good anatomical exposure essential for efficient, accurate, total removal of cerebellopontine angle neoplasms and allows adjacent, uninvolved neurological structures to be spared. Modifying the anatomical exposure by varying the size and shape of the osseous craniectomy and placing the dural incision closer to the porus acousticus permits extradural retraction of the cerebellum. Thus large cerebellopontine angle neoplasms can be excised with less chance of damage to the cerebellum and smaller risk of hydrocephalus. The suboccipital craniectomy may be extended anteriorly to the facial nerve, thereby combining the suboccipital with the translabyrinthine approach, and providing a more direct angle to a large neoplasm involving the brain stem and cerebellum.
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PMID:Suboccipital surgical approach to the cerebellopontine angle and internal auditory canal. 30 63

The patient is a 17-year-old female. She was suffering from dwarfism, irregular menstruation and obesity. Out of the dwarfism, there were no other neurological abnormalities. The serious clinical examinations were performed, and the cerebral angiography and the CT scan demonstrated the findings of the obstructive hydrocephalus. Namely, enlarged IIIrd ventricle and small IVth ventricle were observed with routine CT scan. Because these findings on CT scan, we thought the hydrocephalus was based on the aqueductal stenosis. The vertebral angiography showed stretched posterior medial choroidal arteries and compressed the basilar tip posteriorly and inferiorly. Moreover, the carotid-angiography demonstrated the following findings, unrolling of the anterior cerebral arteries laterally stretched bilateral lenticulostriate arteries laterally shifted sylvian groups of the middle cerebral arteries, and stretched bilateral internal cerebral veins. Judging from that angiographic findings and CT scan, we thought there would be cystic tumor in the IIIrd ventricle. However, we suspected the IIIrd ventricular tumor, we were not able to differentiated it from the enlarged IIIrd ventricle itself exactly. Because, it's density in CT scan was equaled with that the cerebrospinal fluid. According to above facts, we performed "Amipaque CT ventriculography through the ventricular catheter after V-P shunt. By "the Ampiqque CT ventriculography" we found exactly there was large cystic tumor in the IIIrd ventricle. Their manifestation and some differential diagnosis were discused.
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PMID:[Diagnosis of IIIrd ventricular cyst with "amipaque (metrizamide) CT ventriculography (author's transl)]. 30 73

Metrizamide CT cisternography (CTC) was performed for the evaluation of CSF dynamics and the diagnosis of skull-base tumors. Results of CTC in 52 cases examined for the study of CSF dynamics correlated well with those of isotope cisternography. However, the degree and duration of ventricular stasis of metrizamide and its transition into a periventricular low-density area in hydrocephalus were recognized more accurately in CTC. Twenty out of 23 cases with suspected skull-base tumor were diagnosed as positive and confirmed by operation. CTC was especially useful in parasellar, CP angle, and other posterior fossa tumors.
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PMID:Diagnostic value of CT cisternography with intrathecal metrizamide enhancement, comparison with isotope cisternography. 31 Sep 81

Cranial computed tomography permitted an in vivo classification of brain edema. The distinction of the four basic types of edema (vasogenic, ischemic, cytotoxic, and periventricular) was important in establishing the chronicity, extent, and pathologic basis of cerebral abnormalities. Vasogenic edema (neoplasm, abscess) was readily distinguished from cytotoxic edema by the predominant involvement of the white matter and associated abnormal enhancement following intravenous contrast medium injection. The diminished density of ischemic edema was visualized in both gray and white matter and occurred in a vascular distribution. An absence of enhancement in the cerebral capillary bed and attenuation or nonvisualization of the circle of Willis following the rapid bolus injection of iodinated contrast medium defined an arrest of cerebral circulation as might be seen in brain death. Periventricular interstitial edema was most often a marker of acute or subacute obstructive hydrocephalus.
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PMID:Brain edema defined by cranial computed tomography. 31 99


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