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Query: UNIPROT:Q9BWK5 (MRI)
 85,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence and clinical significance of peritumoral brain edema in pediatric patients is not well understood. The purpose of this study is to clarify the clinical significance of peritumoral brain edema in pediatric patients. Seventy seven pediatric patients (under 15 year old) with brain tumor were studied by MRI. The volume of peritumoral edema and brain tumor were measured by integration of the cross-sectional area on serial MRI. The severity of brain edema was expressed by the ratio of edema volume to tumor volume. The results were compared with that of 408 adult patients with brain tumor. Incidence of the brain edema associated with supratentorial tumors is lower in pediatric group than in adult. Severity of brain edema is also less extent in the pediatric group. Forty two percent of supratentorial gliomas in pediatric group showed peritumoral edema. On the other hand, 63% of adult group showed peritumoral brain edema. In general, pediatric brain tumors rarely associated with marked peritumoral brain edema which observed in the adult group. However, intraventricular or paraventricular tumors with obstructed hydrocephalus showed remarkable brain edema in pediatric group. Low incidence and less severity of peritumoral edema are caused not only by histological bias of tumors, but also by the biological nature of developing brain.
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PMID:Peritumoral brain edema associated with pediatric brain tumors: characteristics of peritumoral edema in developing brain. 797 97

A 76-year-old man presented with gait disturbances, mental deterioration and urinary incontinence. CT and MRI suggested a normal pressure hydrocephalus. Because of a raised protein content of CSF, a spinal MRI was performed and revealed a lumbar neurinoma. The patient improved after removal of the neurinoma and ventricular derivation.
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PMID:[Normal pressure hydrocephalus and lumbar neurinoma]. 799 43

The treatment of cerebral arteriovenous malformations (AVM) or vascular anomalies are challenging neurosurgical procedures for an anaesthetist. Large AVMs are uncommon in children. Only 18% of AVMs become symptomatic before the age of 15 yr. This series reviews the experience at this institution during the period of 1982 to 1992. The symptoms at the time of presentation are varied and include haemorrhage (50%), seizures and hydrocephalus (36%) or congestive cardiac failure (18%). Symptoms of congestive heart failure predominate in the newborn whilst neurological symptoms, such as stroke, seizures or hydrocephalus occur more commonly in infants and older children. Approximately one third of AVMs in childhood present acutely. Radiological investigations, e.g., CT scan, MRI and cerebral angiography are essential to identify the precise location of the lesion. Therapeutic intervention in the acute presentation may involve craniotomy for evacuation of haematoma and treatment of increased intracranial pressure (ICP). Control of seizures and congestive heart failure may take priority and allow time to plan the elective procedures of embolization and surgical excision of the AVM. Operative intervention is hazardous and peroperative complications can be expected in more than 50% of patients. The morbidity and mortality associated with cerebral AVM are high, especially in infants who present in the neonatal period with congestive cardiac failure. The overall mortality in this series was 20%. Children presenting with intracranial arteriovenous malformations require a multidisciplinary approach. The successful management of anaesthesia either for embolization or surgical resection necessitates an understanding of the disciplines of paediatric and neuroanaesthesia. Special care and specific attention to detail may contribute to reduce the high morbidity and mortality encountered in these compromised children.
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PMID:Cerebral arteriovenous malformations in children. 800 40

In a series of 571 vestibular schwannomas (VS) operated on in the period 1976-1992, via the translabyrinthine approach, 23 tumours (4 per cent) from 23 patients were radiologically, peroperatively and histologically identified as cystic VS. Neuroimaging examinations (CT and MRI) revealed 15 tumours (2.6 per cent) with extracystic formations and in eight cases (1.4 per cent) intratumoural cysts. In 15 cases (65 per cent), tumours were located extracanalicularly with no involvement of the internal auditory canal (IAC). The extracanalicular tumour extension including the cystic elements ranged between 10 and 60 mm with a mean of 45 mm. In eight cases out of 23 (35 per cent) other diagnostic possibilities such as trigeminal schwannoma, epidermoid cyst and meningioma were proposed at the primary evaluation. Deformation, displacement and/or impression of the fourth ventricle was demonstrated in 17 cases (74 per cent). Three patients (13 per cent) had obstructive hydrocephalus which demanded shunt insertion. Residual tumour was detected in two patients (9 per cent). Growth rate in four cases was more than 10 times higher when compared to the annual growth rate of noncystic VS. The results of this study provide data on cystic VS attenuation demonstrated by CT or MRI which may be valuable in neuroradiological diagnosis of these cystic lesions and emphasizes that the wait-and-see policy should not be applied to the cystic variant of VS.
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PMID:Cystic vestibular schwannomas: neuroimaging and growth rate. 803 13

The authors report on a case of Paget's disease with hydrocephalus in an elderly female with a favourable result after ventriculoperitoneal shunt. The neurological examinations at the time of admission revealed mild dementia, ataxic gait and urinary incontinence. Skull X-ray, CT-scan and MRI showed hydrocephalus and basilar impression. The pathophysiological hypothesis is discussed and the technical difficulties during the shunt surgery are described.
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PMID:Management of hydrocephalus in Paget's disease. Case report. 805 79

Four cases of pineal cyst were presented and their features on magnetic resonance (MR) imaging were discussed while reviewing the literature relevant to this clinical entity. Pineal cyst is a normal developmental variant and in most of the cases its diagnosis is not difficult, but in a limited number of cases, pineal cyst needs to be differentiated from cystic tumors which have developed in the region of the pineal gland, such as pineocytoma or astrocytoma. Most pineal cysts are found incidentally during MR screening studies and no surgical interventions are needed. Pineal cysts should be considered for surgery only when the diameter of the cyst is more than 1.0cm, or when obstructive hydrocephalus is verified on MRI or CT, and/or when definitive neurological signs such as Parinaud's syndrome are present. It was also stressed that embryological considerations are indispensable for evaluating pineal cysts on MR images.
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PMID:[Pineal cyst: its diagnosis and treatment]. 807 28

A rare case of mature pineal teratoma with interesting radiological findings in a 16-month-old infant is reported. The patient was referred to our clinic because of generalized convulsions. A CT scan showed marked hydrocephalus and a low density mass lesion without contrast enhancement in the pineal region. A CT cisternography demonstrated the lesion as a filling defect area on the image produced immediately after the emergent V-P shunt, and a filling area 24 hours later. The lesion was of signal intensity on T-1 weighted MR image and of high signal intensity on T-2 weighted MR image, equal to CSF intensity. These radiological findings were compatible with an arachnoid cyst in the quadrigeminal cistern, so we performed the excision of both anterior and posterior cyst walls using the occipital tentorial approach. However, the histology of the cyst wall was not compatible with that of an arachnoid cyst, showing neuroepithelial-like cell lining with positive staining for cytokeratine. The postoperative follow-up on MRI was continued for 31 months. An MRI performed 9 days after the first operation showed, compared with the gray matter, iso-signal intensity area and high signal intensity area on T-1 weighted image. At first, we thought this was because of bleeding of the pineal gland brought on by the operative maneuver. However, the mixed intensity lesion shown on T-1 weighted images gradually expanded and distorted, and finally showed the typical MR images for a teratoma. The operative findings using the occipital transtentorial approach were typical for a teratoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of pineal teratoma with interesting radiological findings]. 807 38

Cerebellar infarcts have been neglected for a long time and are now shown well by CT and especially MRI. Some infarcts involve the full territory supplied by a cerebellar artery. They are frequently complicated by edema with brain stem compression and supratentorial hydrocephalus, requiring at times emergency surgery, and are often accompanied by other medullary, medial pontine, mesencephalic, thalamic and occipital infarcts. On the other hand, partial territory infarcts are usually confined to the cerebellum and have a benign outcome with total recovery or minimal disability. They are more common than full territory infarcts. However, clinical presentations are similar to those full territory infarcts, differing mainly by the lack of drowsiness or unconsciousness. The main symptoms are vertigo, headache, vomiting, unsteadiness of gait and dysarthria. Signs include ipsilateral limb dysmetria, ipsilateral axial lateropulsion, ataxia and dysarthria. Vertigo is more severe and rotary in posterior inferior cerebellar artery territory infarcts, whereas dysarthria and ataxia are prominent in superior cerebellar artery territory infarcts. A few brain stem signs are sometimes added. In these territorial cerebellar infarcts, cardioembolism is the most common cause. Atherosclerotic occlusion comes next, involving the intracranial part of the vertebral artery and, less frequently, the lower basilar artery, both locations inaccessible to surgery. Other causes are artery to artery embolism from a vertebral artery origin stenosis, or the aortic arch, in situ intracranial branch atherosclerotic occlusion, and vertebral artery dissection. Border zone cerebellar infarcts occur in one third of the cases. They are small cortical or deep infarcts. They have the same symptoms and signs as territorial infarcts except for more frequent postural symptoms occurring over days, weeks or months after the ischemic event. The infarcts mainly have a thromboembolic mechanism, and sometimes have a hemodynamic mechanism: 1) focal cerebellar hypoperfusion due to large artery occlusive disease in more than half the cases, 2) small or end (pial) artery disease due to hypercoagulable state (thrombocythemia, polycythemia, hypereosinophilia, disseminated intravascular coagulation), arteritis or intracranial atheroma, and 3) rarely systemic hypotension due to cardiac arrest.
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PMID:[Cerebellar infarctions and their mechanisms]. 809 Oct 85

A group of 159 patients with tumours in the anterior part of the third ventricle and surrounding region were analysed. According to WHO classification the tumours belong to groups I, V, VI and VII. The assessment of neurological manifestations and hormonal abnormalities makes possible their early diagnosis. CT of the head and MRI inform about the location, character and extent of the intracranial mass. Angiography provides important information on the vascularization of the tumour and its relation to the vessels of the anterior part of Willis circle and hypothalamic veins. In the surgical treatment in 37 cases microsurgery was used reducing the perioperative mortality by half. Hydrocephalus associated with the tumours was treated either by atrioventricular drainage or, when the tumour was partly removed, pellucidotomy was done. Radiotherapy was the next stage in the treatment of tumours of this location.
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PMID:[Occurrence of tumors in the anterior part of the third ventricle and in adjacent structures in patients of the Department of Neurosurgery, Medical Academy in Poznan]. 811 93

We report 3 patients, ages 5, 9 and 13 years, with mutism following posterior fossa surgery (PFS). All presented with headache of 10-180 days duration, excellent premorbid learning performance and paucity of neurologic signs. Radiographic studies demonstrated large posterior fossa tumor occupying the fourth ventricle, and hydrocephalus, leading to gross total resection of the tumor. Within 24-48 hr, all patients were mute. None had problems with swallowing and coughing. All were able to nod "yes or no," follow commands, point to body parts, and make their wants known by gestures. Jaw, gag, snout and palmomental reflexes were normal. CT scan and MRI Brain showed no cerebral hemispheric lesions. All children regained speech although dysarthric, within 5-12 weeks. Twenty-two previously reported cases are similar to ours. We conclude that this post-surgical mutism syndrome is unique and must be differentiated from aphemia, Broca's aphasia, hysterical mutism and elective mutism. The cerebellum, in a way not yet understood, does play a role in speech production.
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PMID:Transient mutism following posterior fossa surgery in children. 812 Nov 85


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