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

Thirty-two patients suffering from high-grade glioma were candidates for superselective cerebral arterial infusion of 1,3-bis-(2-chloroethyl)-1-nitrosourea (BCNU) after surgery and radiation therapy. There were 74 catheterizations using an 8-French guiding catheter through which a 2.5-French balloon catheter was placed into the main arterial trunk feeding the tumor. Eleven procedures were abandoned because of arterial spasm with a transient neurological deficit or because of prolonged catheterization time. Sixty-three infusions of BCNU were done, each lasting three hours. Eighty-one percent of patients showed stabilization or improvement on computed tomographic (CT) scans five weeks after treatment. We thus demonstrate the safety of supraophthalmic catheterization, the feasibility of prolonged catheterization, and the relative effectiveness of low doses of BCNU infused over a long period of time in the treatment of cerebral gliomas.
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PMID:Superselective cerebral arterial infusion of BCNU in high-grade glioma: the radiologist's point of view. 297 Oct 50

A 54-year-old man was admitted to our hospital complaining of back pain and right hypochondrial pain. Ultrasonography and celiac angiography revealed a large tumor sized 9.4 X 8.1 cm. The tumor appeared hypervascular on angiogram. During the second angiography, an attempt at superselective hepatic angiography for the purpose of infusing a combination of Adriamycin and Lipiodol, spasm of the celiac artery occurred. High fever continued for 11 days after the spasm and serum transaminase was elevated. At the third angiography, the nature of the tumor was seen to have changed remarkably to one of hypovascularity. Percutaneous transhepatic tumor biopsy was done. Pathological diagnosis was necrosis of hepatocellular carcinoma. Due to heart disorders, ligation of the right hepatic artery was performed instead of hepatic resection. Postoperatively, the size of the tumor decreased further. It is thought that this patient had a tendency to suffer from vasospasm and that the tumor had a relatively low resistance to ischemia.
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PMID:[A case of necrosis of a hepatocellular carcinoma, caused by spasm of the celiac artery]. 303 94

Arterial spasm is rarely encountered in the uncomplicated cervical lymphadenectomy. Intense, often dramatic, vasospasm of the internal carotid artery, however, is not infrequently observed in the removal of skull-base lesions. This myogenic reaction is independent of autonomic innervation, occurs more frequently in younger patients, and appears to be due mainly to longitudinal arterial traction and prolonged arterial contact with fresh blood. A case of severe internal carotid artery spasm, which led to a fatal stroke in a young woman who underwent removal of a large glomus jugulare tumor, is presented to emphasize not only the lethal potential of carotid spasm, but intraoperative changes in the character of the artery which suggest the need for immediate spasmolysis. Perioperative guidelines for the prevention and treatment of arterial spasm--including topical and systemic pharmacotherapy and refined surgical techniques--are outlined on the basis of our subsequent experience.
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PMID:Carotid artery vasospasm complicating extensive skull base surgery: cause, prevention, and management. 303 41

A hemifacial spasm was symptomatic of a neurinoma of the hypoglossal nerve in a 50 year-old woman. It disappeared after the surgical cure of the tumor. Hemifacial spasm is not mentioned among the 19 cases of neurinoma of the hypoglossal nerve which have been reported up to now. The spasm could have been due to the compression of the 7th nerve by the anterior inferior cerebellar artery, displaced by the tumor.
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PMID:[Hemifacial spasm disclosing neurinoma of the hypoglossal nerve]. 307 Jun 95

Hemifacial spasm (HFS) due to intracranial mass lesions is rare. Most cases are thought to be due to compression of the facial nerve by small vessels near the root of the facial nerve. A survey was undertaken of all botulinum toxin investigators to determine the incidence of imaged mass lesions causing HFS. Responders contributed information on 1676 patients with HFS. Of this group, nine tumors were reported for an incidence of 0.54% of patients. However, of this group only 52.5% underwent computed tomography (CT) or magnetic resonance (MR) scanning so the incidence of tumor causing HFS could be as high as 1.0%. No one tumor type was predominant, and most patients were women older than 50 years of age. The incidence compares with another large series of HFS patients in which one tumor was found in 367 patients. The authors also report as an illustrative case a 26-year-old man with HFS due to a presumed lipoma of the cerebellopontine angle. This diagnosis can be made with increased certainty with MR scanning. If the incidence of unsuspected diagnostically significant mass lesions is 1 in 200 patients with HFS referred for botulinum toxin injection, the cost of detecting one such lesion would be $100,000 at an average imaging cost of $500 per MR imaging or CT examination. Although mass lesions are uncommon, any patient with HFS whose general clinical course could justify intervention should be considered for imaging studies to rule out treatable conditions other than vascular compression.
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PMID:Hemifacial spasm due to intracranial tumor. An international survey of botulinum toxin investigators. 326 3

A case of tentorial cavernous angioma is reported. A 61-year-old woman was admitted because of left auditory disturbance and left hemifacial spasm. CT scan and angiography, MRI revealed a dumb-bell typed tumor extended above and below the left tentorium cerebelli. Under the preoperative diagnosis of tentorial meningioma, a craniotomy was performed and the tumor was removed totally with minimal bleeding by left subtemporal approach. The tumor was well capsulated and spongy, attached to the tentorium cerebelli. Histologically, the tumor had many various vascular cavities with the wall lined with a single layer of endothelial cell, had neither glial cell nor meningeal cells. Some of cavities were thrombosed. Pathological diagnosis was a cavernous angioma. We discussed the characters of this rare tumor with a review of 4 cases.
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PMID:[A case of tentorial cavernous angioma]. 329 Jun 96

Radiography plays an essential part in the diagnosis of spinal disease in the dog. Careful positioning of the patient and attention to technique are important in obtaining diagnostic films and sedation or general anaesthesia is usually required, especially if the animal is in pain or muscle spasm. Additional information may be obtained by myelography, a technique in which a water-soluble iodine-containing contrast medium is injected into the subarachnoid space via the cisterna magna, under general anaesthesia. The advent of two new contrast media, iopamidol and iohexol, has rendered this a relatively safe procedure which may be carried out in practice. The radiological features of a variety of canine spinal conditions are discussed, including congenital and developmental abnormalities, infective, nutritional and degenerative conditions and trauma and neoplasia.
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PMID:Radiographic examination of the canine spine. 330 14

Six cases of acoustic neurinoma (AT) with preoperatively preserved hearing are presented. Their clinical features and surgical management for hearing preservation are discussed. Presenting symptoms were hearing decrease in 3 cases (#1, #2, #6), trigeminal neuralgia in 3 cases (#4, #5, #6), and hemifacial spasm in case #2. Case #3 was an incidentally diagnosed case by CT scan. Preoperative decrease of hearing in the affected ears ranged from 10 dB to 60 dB. In all cases except for case #1, CT scans revealed CP angle tumors sized 1 - 4 cm in diameter. A small intracanalicular tumor was detected in case #1 by metrizamide CT scan. Enlargement of the internal auditory meatus was detected in two cases (#4, #6). Through a lateral suboccipital transmeatal approach, all cases underwent radical total resection of tumor with anatomical preservation of both facial and cochlear nerves. Postoperatively, in spite of good morphological preservation of cochlear nerve, useful hearing function was noted in only one case (#3) who had excellent preoperative hearing (10 dB) and whose tumor was very small (1 cm). Facial nerve function was satisfactory in all patients. According to the previous reports, the level of hearing decrease in AT is related to the origin of tumor, direction of its growth, invasions or involvement to cochlear nerve and extension toward the labyrinth. Major factors to achieve preservation of useful hearing in AT surgery are 1) size of the tumor and 2) preoperative hearing acuity. Early detection of small tumor is extremely important and surgery must be precise to preserve cochlear nerve, internal auditory artery and labyrinth.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Management of acoustic neurinoma with preserved hearing]. 332 33

Retrolabyrinthine surgery is done to expose the cerebellopontine angle directly through the ear. It is indicated when the hearing in the ear to be operated upon is useful. The surgical technique entails four steps: complete mastoidectomy, extended posterior exposure of the sigmoid sinus, exposure of the posterior fossa dura, and exposure of the cerebellopontine angle. Retrolabyrinthine exposure of the cerebellopontine angle is indicated in tic douloureux, atypical facial pain, and hemifacial spasm. Recently, this approach has been used for sectioning the vestibular nerve, exploration of the posterior fossa to obtain a diagnosis, subtotal resection of large cerebellopontine angle tumors, and for the treatment of other cranial nerve problems. The histopathologic findings in the temporal bones of two patients who underwent retrolabyrinthine removal of cerebellopontine angle masses were reviewed. In one, subtotal resection of an acoustic tumor was attempted to preserve hearing in the presence of a bilateral tumor, with no adverse effect on the middle or inner ear. In the second, retrolabyrinthine exploration of the cerebellopontine angle was done for primary cholesteatoma, and operative injury to the nonampullated end of the posterior semicircular canal was noted. Retrolabyrinthine subtotal resection of large acoustic tumors is advocated in bilateral cases and in elderly persons to delay the inevitable loss of hearing by decompression and partial removal of the tumor mass. In primary cholesteatoma of the cerebellopontine exploration may be indicated to obtain a definitive diagnosis before surgical extirpation of the disease is planned.
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PMID:Retrolabyrinthine surgery: anatomy and pathology. 348 6

Delayed neurologic deterioration from vasospasm remains the greatest cause of morbidity and mortality following subarachnoid hemorrhage. The authors assess the incidence and clinical course of symptomatic vasospasm following subarachnoid hemorrhage using a uniform management protocol over a 24-month period. One hundred eighteen consecutive patients were admitted to the neurovascular surgery service within 2 weeks of subarachnoid hemorrhage not attributed to trauma, tumor, or vascular malformation (113 patients had aneurysms). Early surgery was performed whenever possible, and hypertensive hypervolemic hemodilution therapy was instituted at the first sign of clinical vasospasm. Forty-two patients (35.6%) developed characteristic signs and symptoms of clinical vasospasm with angiographic verification of spasm in 39 cases. All patients with clinical vasospasm received hypervolemic hemodilution therapy aiming for a hematocrit of 33-38%, a central venous pressure of 10-12 mm Hg (or a pulmonary wedge pressure of 15-18 mm Hg), and a systolic arterial pressure of 160-200 mm Hg (120-150 mm Hg for unclipped aneurysms) for the duration of clinical vasospasm. Over the course of treatment, 60% of patients with clinical vasospasm had sustained improvement by at least 1 neurologic grade, 24% maintained a stable neurologic status, and 16% continued to worsen. At the end of hypervolemic hemodilution therapy, 47.6% had become neurologically normal, 33.3% had a minor neurologic deficit, and 19% had a major neurologic deficit or were dead. There were 3 instances of cardiopulmonary deterioration (7%), all of which were in patients without Swan-Ganz catheters, and all resolved with appropriate diuresis. One patient rebled and died while on hypervolemic hemodilution therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical vasospasm after subarachnoid hemorrhage: response to hypervolemic hemodilution and arterial hypertension. 356 92


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