Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Increased intracranial pressure and papilledema are occasionally observed in patients harboring spinal tumors in the cervical region or at the craniocervical junction, and the mechanical obstruction to the cerebrospinal fluid circulation is assumed to be responsible for such symptoms and signs. However, increased intracranial pressure is very rare in spinal tumors locating in the dorso-lumbar region; only 44 such cases having been reported in the literature. Recently we saw a 58-year-old female who presented with three brief episodes of loss of consciousness associated with nausea and vomiting, progressive dementia and insomnia. Neurologic examination disclosed an early papilledema, weakness of both legs and dementia. A left carotid angiogram revealed a small aneurysm arising from C2 segment of the internal carotid artery. Right carotid and bilateral vertebral angiograms were not contributory. The aneurysm was clipped at the first operation. The aneurysm was found apparently unruptured. A ventriculoperitoneal shunt failed to improve her dementia. Finally, a total myelographic block was found at L1 level, and a neurinoma arising from the right D12 was removed. After this, all symptoms and signs disappeared within 3 weeks. Pertinent literature on the low spinal cord tumor associated with an intracranial pressure was reviewed and the mechanism of the elevation of intracranial pressure in such cases were discussed.
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PMID:[Thoraco-lumbar spinal tumor associated with papilledema (author's transl)]. 91 17

Subfrontal schwannomas are rare lesions. They can be misdiagnosed as olfactory meningiomas or neuroblastomas. We report a case of giant schwannoma involving the anterior cranial fossa; the frontal and ethmoid sinuses and nasal cavities. The patient presented with a year-long history of increasingly severe headache associated with insomnia. Examination revealed no neurological deficit except for the anosmia. Magnetic Resonance Imaging revealed a 9x5x3 cm intranasal-subfrontal extraaxial mass. Nasal biopsy indicated the presence of a schwannoma. The lesion was totally removed through a bifrontal craniotomy and the skull base was repaired with periosteal flap, fibrin glue and a split craniotomy graft. In addition to the cosmetic advantages over standard transfacial approaches, the extended subfrontal approach also provides early dissection of neural tissues, avoiding an inadvertent cerebrospinal fluid leak.
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PMID:Nasal-subfrontal giant schwannoma. 1910 91