Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Factor VII deficiency is characterized by epistaxis, bruising, hemarthrosis, menorrhagia, gastrointestinal bleeding, hematuria, and intracranial hemorrhage during infancy. Causes of acquired factor VII deficiency include liver disease, Vitamin K deficiency, and warfarin administration. Congenital factor VII deficiency is an autosomal recessive disorder, with the homozygotes having a severe deficiency and the heterozygotes a moderate deficiency of factor VII. Orthopedic, gynecological, cardiothoracic, and abdominal surgical procedures have been successfully performed in patients with factor VII deficiency both with and without factor VII replacement. We present two patients with moderate and moderately severe factor VII deficiency who successfully underwent intracranial procedures using plasma during the perioperative period for factor VII replacement. One patient successfully underwent stereotactic placement of mesial temporal lobe depth electrodes and subdural strip electrodes followed by anterior temporal lobectomy for medically refractory seizures. The second patient successfully underwent craniotomy for an olfactory groove meningioma. No bleeding complications were encountered with any of the three intracranial procedures performed. These cases represent the first reported cases of successful intracranial procedures in patients with factor VII deficiency, other than shunting procedures performed for intraventricular hemorrhage during infancy.
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PMID:Uncomplicated stereotactic and open neurosurgical procedures in patients with factor VII deficiency. 794 Jan 2

A patient presented with late onset seizure due to sphenoid ridge meningioma excision, during a craniotomy. Nine years after craniotomy, sphenoid ridge meningioma recurred in this patient along with middle cerebral artery (MCA) aneurysm. Peripheral intracranial aneurysm has been shown to be caused by many etiologies. But a direct relationship to an intracranial neoplasm is extremely rare. A causal relationship between the growth of the tumor and the development of the aneurysm is postulated.
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PMID:An intracranial aneurysm associated with a recurrent meningioma--a case report. 795 10

Meningiomas arising in the first two decades of life are uncommon and their characteristics are controversial. Some authors believe meningiomas in younger patients occur in different locations, have more malignant histological features, and have a worse prognosis than those in adults. To address this controversy, the authors retrospectively reviewed 23 cases of meningiomas in patients under 21 years of age at diagnosis who were operated on at the University of Turin (1948 to 1990) or at the University of California, San Francisco (1970 to 1989). These tumors represented 2.9% of all tumors in this age group and 1.8% of all meningiomas during the study period at the two institutions. There were 14 males and nine females. The mean age at surgery was 13.3 +/- 5.6 years; nine cases occurred in the first decade and 14 in the second. The most common neurological symptoms were a focal neurological deficit (33%) and seizures (25%). Seventy percent of the tumors were supratentorial. A gross total resection was performed in 60% of the cases. Histologically, the majority (74%) of the tumors were meningothelial or mixed. An increased number of mitoses was observed in 33% of the tumors, focal necrosis in 29%, and invasion of adjacent brain in 14%; however, none of the tumors was classified as a Grade III (anaplastic) meningioma. All patients are alive without evidence of recurrent disease 3 to 22 years (mean +/- standard deviation: 10 +/- 7.3 years) after surgery. This study confirms the rarity of meningiomas of the first two decades of life and the absence of the female predominance associated with meningiomas in adults. The location and histological features of these tumors are similar to those in adults; they have a low recurrence rate, and the outcome and survival rate are excellent.
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PMID:Intracranial meningiomas of the first two decades of life. 811 57

Sarcoma metastatic to the brain is uncommon and rarely occurs as the initial manifestation of tumor. Alveolar soft-part sarcoma, a rare but well studied subtype of a soft tissue sarcoma with a propensity for central nervous system invasion, presenting with brain metastases, has been reported only once previously. We report the case of a 28-year-old man who presented with partial seizures and who was found to have a homogeneously enhancing frontal lesion on a broad dural base disclosed by computed tomography. preoperatively, the lesion was thought to be a meningioma. The tumor was excised easily and had features typical of an alveolar soft-part sarcoma, which were revealed by light and electron microscopy as well as immunohistochemical analysis. Multiple lung nodules compatible with metastases were found on a chest film. Meningeal dissemination has been reported in a variety of sarcoma types, including rhabdomyosarcoma, fibrosarcoma, and leiomyosarcoma. We add alveolar soft-part sarcoma to this list and suggest that increased recognition of the propensity for these tumors to exhibit metastatic spread to the dura should eliminate diagnostic confusion and provide an earlier diagnosis of these rare lesions. The patterns of spread in metastatic sarcoma deserve further study.
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PMID:Metastatic alveolar soft part sarcoma presenting as a dural-based cerebral mass. 812 54

Meningiomas were studied in 60 patients retrospectively. Clinical, operative and histological findings were correlated with the occurrence and extension of peritumoural oedema as measured by computerized tomography. A relationship was found between both oedema and seizures and between oedema and tumour location. No relationship between tumour size, arachnoid breaching, WHO-grade or tumour vascularity and oedema was detected. In four patients with severe pre-operative oedema, cerebral signs and symptoms persisted despite uncomplicated tumour removal. The present study shows that peritumoural oedema is not only epileptogenic but that it can also cause irreversible cerebral damage as well. Since this study purports to demonstrate that meningiomas with intact leptomeninges can show severe peritumoural oedema, the blood barrier breakdown theory cannot be considered as the only aetiological factor.
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PMID:Cerebral oedema associated with WHO-I, WHO-II, and WHO-III-meningiomas: correlation of clinical, computed tomographic, operative and histological findings. 812 53

Forty-two cats underwent craniotomy for removal of a meningioma between 1985 and 1991. Median duration of clinical signs before examination was 1.25 months. All cats had inappropriate demeanor: 48% were dull and 38% were lethargic. Neurological deficits included impaired vision in 93%, paresis in 83%, and seizures in 19%. Computed tomography (CT) showed solitary masses in 86% and multiple masses in 14%. Intraoperative complications included hemorrhage and difficulty excising deep or adherent masses. Anemia in 13 of 42 cats was the most common immediate postoperative complication. Ten of 42 cats had no improvement or a more severe neurological status after surgery. Eight of 42 cats died immediately after surgery; 6 of these were anemic. Of the cats that survived the immediate postoperative period, evaluation 10 to 14 days after surgery showed that 97% (33 of 34) were alert and 79% (27 of 34) had returned to normal behavior. Neurological deficits, except for vision impairment, had resolved in most cats. The duration of follow-up varied from 1.3 months to 55.1 months. Ten cats developed neurological abnormalities from 1 month to 44.2 months after surgery; of these, 6 had tumor recurrence or new growth confirmed by CT scan or necropsy. Overall survival was 71% at 6 months, 66% at 1 year, and 50% at 2 years. Age of cat and location of tumor did not significantly affect survival (P = .1034 and .1851, respectively). There were too few precise measurements of tumor size to make a valid statistical comparison of the effect of size on survival. Location or presence of multiple tumors did not affect final outcome.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results of craniotomy for the treatment of cerebral meningioma in 42 cats. 819 79

Seventeen patients underwent surgery between 1981 and 1990 for intractable partial epilepsy arising outside the temporal lobe. Twelve had frontal seizure onset, two parietal, two occipital and one diffusely in the hemisphere. Localization was achieved using extraoperative electrocorticography (ECoG) in five cases and intraoperative ECoG was employed in 12. Fifteen patients underwent cortical resections, but two did not subsequently have a resection. Both of these had porencephalic cysts. Of the 15 who had resections six (40%) were seizure free after a mean of 7.3 years. One (7%) was almost seizure free, six (40%) had worthwhile improvement. Pathological examination revealed oligodendroglioma in three, recurrent meningioma in one, vascular malformations in two, glial hamartoma in one and gliosis in six. One case with gliosis initially was shown to have an underlying malignant astrocytoma 2 years later. All these patients had CT abnormalities prior to surgery. Two patients (13%) had no worthwhile improvement. Pathology in these two was ischaemic neurons and arachnoid thickening. Both had normal CT findings preoperatively. One patient had an increased hemiparesis postoperatively. There were three cases of postoperative infection. It is concluded that extratemporal resection can achieve good results for seizure control and intraoperative ECoG is an effective technique for localizing the epileptogenic area. The presence of a structural lesion carries a particularly favourable prognosis for seizure outcome and surgery should, therefore, be strongly considered in patients with intractable partial epilepsy who have evidence of underlying structural pathology.
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PMID:Cortical resections for intractable epilepsy of extratemporal origin: experience with seventeen cases over eleven years. 821 4

We report a 77-year-old woman who presented with partial seizures and was found to have an enhancing dural-based parietal convexity mass. The lesion enlarged on serial examination by computed tomography (CT) over a one year period. The clinical features and radiologic appearance were compatible with a pre-operative diagnosis of meningioma; however, pathologic findings were typical of a dural cavernous hemangioma. Accumulating evidence suggests that these lesions are an uncommon but distinct type of vascular malformation most often arising from the cavernous sinus, tentorium, or cerebello-pontine angle. With CT, magnetic resonance imaging and angiography, these lesions can closely resemble meningioma in terms of signal characteristics, enhancement pattern, and location. This is of importance both in the practical management of meningiomas where the diagnosis is often based on radiologic studies alone, and in clinical trials where incorrect entry diagnosis should be avoided.
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PMID:Dural cavernous hemangioma: an under-recognized lesion mimicking meningioma. 822 89

Calcification is a well recognized but relatively uncommon feature of prolactin-secreting, growth hormone-secreting and non-functional pituitary tumours. It varies in extent, but rarely exceeds a tiny amount histologically or radiologically. Thyrotroph adenomas are the rarest of the secretory pituitary tumours, accounting for less than 1% of cases, and partial calcification of such lesions has been reported in only three cases. We describe two patients in whom the clinical and biochemical features indicated the presence of a TSH-secreting adenoma and radiology demonstrated a large 'pituitary stone'. One patient, a 59-year-old female, initially presented with hyperthyroidism, aged 18, and was rendered euthyroid by two subtotal thyroidectomies before a pituitary lesion was suspected, over 20 years later. Autonomous secretion of thyrotrophin was demonstrated by dynamic tests, and the failure of exogenous T3 to reduce the serum TSH. In the absence of tumour expansion and compressive symptoms, pituitary surgery was not undertaken. At the age of 56, she developed symptoms of intermittent ataxia and diplopia, culminating in a focal seizure, and was found on CT scan to have, in addition to the pituitary lesion, a parasagittal meningioma. This was successfully removed at craniotomy. In the second patient, a 42-year-old male, the finding of hyperthyroidism in association with an elevated TSH concentration led to the discovery of a pituitary stone which was removed transethmoidally, together with surrounding adenomatous tissue which stained positively for TSH on immunocytochemistry.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pituitary stone: two cases of densely calcified thyrotrophin-secreting pituitary adenomas. 830 73

This paper reports childhood meningioma in association with meningioangiomatosis. The patient was an 11-month-old baby boy who presented with a left focal seizure. He had no stigmata of neurofibromatosis. Computerized tomography and magnetic resonance imaging revealed an extra-axial, contrast-enhancing mass in the interhemispheric fissure which indented the right frontal lobe. The tumor was totally removed. Microscopically, the lesion was a fibrous and transitional meningioma with foci of necrosis and scattered mitotic figures. The adherent neural parenchyma showed the histological features of meningioangiomatosis. It is concluded that meningioangiomatosis may accompany childhood meningiomas more often than is generally appreciated.
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PMID:Childhood meningioma associated with meningio-angiomatosis. Case report. 842 Dec 12


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