Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although recent advance in neurological surgery has diminished mortality rate of aneurysmal surgery, there still exist several complex problems for the management of aneurysms. Persistent neurological deficits or clinical deterioration after subarachnoid hemorrhage can result from subsequent communicating hydrocephalus which can be treated by shunting operation. We have studied alterations in the cerebrospinal fluid (CSF) circulation after SAH in 43 patients. Sources of hemorrhages were aneurysm in 30 cases, arteriovenous malformation in 6 and unknown in 7. Radioisotope cisternography was performed using 0.5 to 1.0 mCi of 169Yb-DTPA which was given intrathecally by lumbar injection. Results of cisternogram were classified into 4 groups and 7 subgroups; group 0: non filling (4%), group I: persistent ventricular filling (45%), A) absence of convexity flow (11%), B) partial convexity flow (34%), group II: transient ventricular filling (23%), A) delayed convexity flow (11%), B) normal convexity flow (12%), group III: no ventricular filling (28%), A) delayed convexity flow (17%), B) normal convexity flow (11%). The radioactivity in serial blood samples was measured by a well-type scintillation counter. Three types of curves for transfer of 169Yb-DTPA from CSF to blood were classified; delayed type, medium type, and normal type. In delayed type, the count ratio of blood activity at 24 hr to that at 3 hr is over 30%. In normal type, it is below 10%. There was a close correlation between cisternogram and transfer curve. In most cases with persistent ventricular filing, the transfer curve showed a delayed type. The relationship of cisternogram to classification of patient's condition by Hunt was studied. The grade of patient's condition was found to be closely related to the degree of abnormality in CSF circulation. The existence of rebleeding in the patients history was also found to influence the degree of abnormality in CSF circulation. However, single bleeding may also cause abnormality, such as persistent ventricular filling on cisternogram. In regard to the site of aneurysms, those of anterior communicating artery appeared to cause communicating hydrocephalus more frequently. Laterality of convexity flow was analyzed in 17 cases. All cases with internal carotid aneurysms showed decreased activity on the side of bleeding. Shunt operation was performed on 10 cases according to the results of cisternography, transfer curve, pneumoencephalography, and angiography. Seven cases showed improvement and 2 died of other complications soon after the shunt, and the effect of the procedure cannot be evaluated. Patients with clinical signs of NPH and abnormal cisternogram (group I) with evidence of ventricular dilatation are indicated for shunting operation.
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PMID:[Radioisotope cisternographic study on cerebrospinal fluid circulation after subarachnoid hemorrhage]. 123 20

The present study was undertaken to assess the usefulness of brain scintigraphy and ultrasound evaluation of changes described in tuberculous meningitis. Brain scans were done with Tc-99m DTPA in 127 cases of tuberculous meningitis (TBM) and ultrasound studies in 41 cases with open anterior fontanelles. The data show that 54/127 (42.5%) of cases had abnormal brain scans, of which 33/54 had cerebrovascular infarcts and 14/54 had tuberculomas, while the remaining cases had either subdural effusions or generalized increased activity. The cerebrovascular infarcts were more frequent in patients with acute onset of TBM with associated hemiplegias. The ultrasound studies indicated that 80% of all cases of TBM had a mild to severe dilatation of the ventricles. About 55% of cases had a dilatation of only the lateral ventricles while the remaining cases had a block of aqueduct or beyond the fourth ventricles. Increased intracranial pressure changes were associated with a higher incidence of severe ventricular dilatation. Noninvasive detection methods in the study of TBM are important not only from the point of view of diagnosis but also to understand and evaluate the pathological changes occurring in vivo during the disease process and to judge the progress and response to treatment. A combination of ultrasound and brain scans offers diagnostic accuracy comparable to CT. Apart from cost, the larger radiation doses resulting from CT studies preclude its routine use in pediatric subjects.
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PMID:Radionuclide scintigraphy of the brain and ultrasound studies in tubercular meningitis. 355 32

Several clinical trials have demonstrated that cisplatin-based chemotherapy for primary intracranial germ-cell tumors is effective as a neoadjuvant chemotherapy. In this report, we describe a 6-year-old boy, Down syndrome and Hirschsprung's disease with intracranial pure yolk sac tumor treated by combined chemotherapy with cisplatin, vinblastine, bleomycin and cyclophosphamide (modified VAB-6 regimen). He had been admitted to our hospital because of intractable vomiting, and left facial nerve palsy since 1 month before. An MRI revealed an enlarged mass, 4cm in diameter, in the left cerebello-pontine angle with uniformal enhancement by Gd-DTPA, and bilateral ventricular dilatation. He was found to have increased serum alpha-fetoprotein level (AFP 11, 786ng/ml), but not human chorionic gonadotropin beta-subunit. After a partial resection of the tumor, diagnosed as pure yolk sac tumor, and ventriculo-peritoneal shunt, three courses of combined chemotherapy with cisplatin, bleomycin, vinblastine and cyclophosphamide (modified VAB-6 therapy) were carried out. The serum AFP level returned to normal, and the tumor mass entirely disappeared (a complete response) on MRI after the second course of chemotherapy. However, cisplatin-induced vomiting and mild neutropenia and renal tubular injury developed after the third course of chemotherapy. Irrespective of administration of recombinant human G-CSF and broad spectrum antibiotics, he suffered from pneumonia and died of septic shock and multiple organ failure. Autopsy showed microscopic residual tumors. The combination chemotherapy with cisplatin, bleomycin, vinblastine and cyclophosphamide is effective for initial treatment of childhood intracranial yolk sac tumor. It is necessary, however, to reevaluate the cisplatin dosage and treatment schedule in order to reduce such side effects as bone marrow suppression and renal damage.
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PMID:[A case report of a 6-year-old boy with intracranial yolk sac tumor treated by VAB-6 regimen]. 753 Dec 96

Twenty-six cases with leptomeningeal metastasis were analyzed and Gd-DTPA enhanced MR imaging was found to be the most useful tool for making the diagnosis. The important manifestations in order of frequency were: 1) leptomeningeal enhancement; 2) ependymal enhancement; 3) plaque, nodule or mass in the subarachnoid space or ventricles; 4) nerve root thickening; and 5) ventricular dilatation not related to the obstruction of the primary neoplasm. A review of the literature has shown that intracranial leptomeningeal metastasis from spinal cord astrocytoma are very rare. In our series, 3 cases with primary brain tumors developed spinal subarachnoid involvement. This paper also reviews 1 case with thoracic cord astrocytoma which developed multiple intracranial leptomeningeal metastasis.
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PMID:MRI manifestations of leptomeningeal metastasis. 800 48

A 67-year-old woman presented with a 1-year history of gradual weight loss, reduced mental activity, muscle weakness, and urinary dysfunction. Neurological examination revealed mild lethargy, severe muscular atrophy, and diminished deep tendon reflexes in the extremities. The levels of vitamin B1 and folate in blood were low: 1.9 micrograms/dl (normal range 2.0-7.2) and 0.7 ng/ml (normal range 4.0-12.0). respectively. A lumbar puncture was done. The pressure of the cerebrospinal fluid was within normal limits, the level of protein was very high (467 mg/dl), and only a few lymphocytes were seen. A nerve-conduction study showed low amplitudes of action potentials and slow conduction velocities in both the motor and sensory nerves. Myelin irregularity, "onion bulb formation", and axonal atrophy were seen in a specimen obtained by sural nerve biopsy. A T2-weighted magnetic resonance image of the brain showed ventricular dilatation, high-intensity signals around the lateral ventricles, and a flow-void sign of the cerebral aqueduct. Radioisotope cisternography (111In-DTPA) disclosed ventricular reflux and slow clearance of the tracer from the ventricles. These findings indicated the presence of chronic inflammatory demyelinating polyneuropathy, nutritional polyneuropathy, vitamin B1 deficiency, folate deficiency, and normal pressure hydrocephalus. In this patient, the high level of protein in the cerebrospinal fluid may have caused the hydrocephalus.
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PMID:[Chronic neuropathy, a high level of protein in cerebrospinal fluid, and vitamin B1 and folate deficiency in a patient with normal-pressure hydrocephalus]. 930 Dec 70

We report a 85-year-old woman who died after one year history of convulsion, dementia, and consciousness disturbance. She was apparently well until January 6, 1995 when she was 85 year old; on that evening, she suddenly stated that some one was in her room and she became confused. A local MD gave her diazepam and she fell into sleep. At 3 o'clock in the following morning, she developed tonic-clonic convulsion in her right lower extremity which showed a march to her right upper extremity and the left lower extremity. She was admitted to our hospital. On admission, she was comatose with respiratory acidosis. She was intubated and placed on a ventilator. She was treated with intravenous phenytoin. She gradually gained consciousness and became alert. Respiration became normal. Her MRI revealed ventricular dilatation, fronto-parietal cortical atrophy, and a T1-low and T2-high signal intensity lesion in the left occipital lobe. She was discharged for out patient follow-up on February 4, 1995. Since then, she noted loss of memory and small step gait. A follow-up CT scan revealed a mass lesion which showed a ring-shaped enhancement in the left occipital lobe and was admitted again. On admission, she was alert but markedly demented. The optic fundi was unremarkable, but she appeared to have right homonymous hemianopsia. No motor weakness was noted. In Gd-DTPA enhanced MRI, the above tumor showed a ring enhancement. The diagnosis of glioblastoma was entertained, however, considering her age, she was treated with intravenous glycerol and intramuscular steroid. She was discharged for out-patient follow-up on July 15, 1995. Her gait disturbance had progressively become worse and she developed nausea and vomiting and was admitted again on October 2, 1995. On admission, she was somnolent and markedly demented. Brain stem responses were retained normally. She was unable to stand or walk. Deep tendon reflexes were slightly increased in the right upper extremity and the plantar response was extensor on the right. Her hospital course was complicated by respiratory tract infection and respiratory acidosis. She expired on November 2, 1995. The patient was discussed in a neurological CPC and the chief discussant arrived at the conclusion that she had a glioblastoma involving the left occipital lobe and the adjacent areas. Post-mortem examination revealed an infiltrating tumor in the left occipital lobe. On microscopic examination, the tumor was very cellular; nuclear atypism was marked and tumor cells undergoing mitosis were seen. In some areas, capillary proliferation was seen. Histologic characteristics were consistent with glioblastoma.
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PMID:[A 85-year-old woman with one year history of convulsion, dementia, and consciousness disturbance]. 936 96

Aqueductal stenosis is induced by widely various causes. These causes include congenital stenosis, tumor or inflammation. Among them vascular malformation is a very rare cause. In this paper we present a rare case of aqueductal stenosis caused by venous angioma. The patient was a 28-year-old female, who suffered from headache and double vision. On admission, CT and MRI showed lateral and third ventricular dilatation not but fourth ventricle, suggested aqueductal stenosis. Gd-DTPA enhanced T1-weighted MR image showed an abnormal draining vein passing through the orifice of the aqueduct. Angiography demonstrated the umbrella sign which was specific sign of the venous angioma. We performed endoscopic third ventriculostomy. Postoperative neuroradiological examination showed shrinkage of the ventricles and the symptom of the patient improved markedly. In the past literatures, five cases of aqueductal stenosis due to venous angioma have been reported. Although venous angioma is congenital, all five cases had been symptomatic at adult stage. Detailed evaluation of pre-and post-operative MRIs suggest that aqueductal stenosis induced enlargement of the lateral and third ventricles, which led narrowing of the suprachiasmatic cistern and the peri-mesencephalic cistern, and downward displacement of medulla and tonsil into the foramen magnum. As a result, hydrocephalus is aggravated gradually.
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PMID:[A rare case of aqueductal stenosis due to venous angioma]. 1572 82