11/30. Benign symptomatic glial cysts of the pineal gland: a report of seven cases and review of the literature.Seven cases of clinically symptomatic benign glial cyst of the pineal gland are reported. The cysts' size ranged from 1.0-4.5 cm in diameter. They were characterised by a golden or, less frequently, brown-reddish proteinaceous or haemorrhagic fluid content. The cyst wall, up to 2 mm thick, consisted of clusters of normal pineal parenchymal cells, often compressed and distorted, surrounded by reactive gliotic tissue which sometimes contained Rosenthal fibres. The presenting clinical features included headache (6/7), signs of raised intracranial pressure, partial or complete Parinaud's syndrome (5/7), cerebellar deficits (2/7), corticospinal and corticopontine fibre (2/7) or sensory (1/7) deficits, and emotional disturbances (2/7). CT and MRI (in 2/7 cases) scans showed a hypodense or nonhomogeneous lesion in the region of the pineal gland, with or without contrast enhancement. Surgical excision resulted in complete clearance of the symptoms in 5/7 patients. The previous literature is reviewed and the clinicopathological correlations and the possible pathogenetic mechanisms are discussed. The need to distinguish this benign lesion from other mass lesions of the pineal region, in particular from pinealocytoma, is stressed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
12/30. Unilateral neglect and constructional apraxia in a right-handed artist with a left posterior lesion.A rapidly growing tumor in the left posterior parietal lobe of a right-handed, 72 year old artist resulted in bilateral neglect and constructional apraxia that were greater on the right side of his painting than on the left. These changes indicate that a left posterior parietal lesion alters visuospatial perception and constructional ability on both sides of a painting with the contralateral hemispace more impaired than the ipsilateral hemispace. Primitivization of emotional expressions on human faces also occurred.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
13/30. artifacts and diagnostic pitfalls on magnetic resonance imaging: a clinical review.High field MRI of the brain occasionally exhibits imaging artifacts; most artifacts are obvious and easily recognized, but some are subtle and mimic disease. A thorough understanding of brain MRI artifacts is important to avoid potential diagnostic pitfalls. Some imaging techniques or procedures could be utilized to remove or identify artifacts. These include additional projections, different pulse sequence, and 90 degree shift of phase-encoding gradient. The use of respiratory gating or cardiac gating may also improve image quality by reducing some of the motion-related artifacts.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
14/30. Acute presentation of memory loss and emotional lability.A 35-year-old woman presented complaining of memory loss and increased emotional lability. On physical examination she was noted to be poorly oriented, have profound recent and remote memory defects, and to have mild but significant lateralizing signs. Inpatient work-up included EEG, computed tomography scan, and cerebral angiography, culminating with a brain biopsy that revealed a Grade IV left temporal astrocytoma. The patient was discharged and received outpatient radiotherapy before dying 12 weeks after presentation.- - - - - - - - - - ranking = 5keywords = motion (Clic here for more details about this article) |
15/30. Resolution of saccadic palsy after treatment of brain-stem metastasis.A 65-year-old man was unable to generate normal horizontal saccadic eye movements. Smooth pursuit of sinusoidal target motion was normal. The saccadic palsy resolved rapidly, twice, after treatment with intravenous corticosteroids. Computed tomography showed a lesion in the pons, and seven months later he was found to have metastatic adenocarcinoma.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
16/30. brain tumor with ipsilateral cerebral hemiatrophy in children.A series of six cases of cerebral tumor with ipsilateral cerebral hemiatrophy, including four cases admitted at our institute, were studied. Various common clinical features were noted in these six cases. The mechanism whereby ipsilateral hemiatrophy of the cerebrum arises from brain tumor has been discussed on the basis of symptomatologic and clinicopathologic findings noted in these 6 cases. 1) The onset of the disease was between 8 and 14 years of age with a mean of 11 years and 8 months; thus all the 6 patients being juvenile. 2) Presenting symptoms developed from 1 year and 2 months to 4 years before admission, with an average of 2 years and 1 month. The clinical course was therefore relatively chronic in every case. 3) Presenting symptoms were: decline of school work, hemiparesis and loss of consciousness. These symptoms were all progressive throughout the course. The principal symptoms were hemiparesis, hemihypoesthesia, character and emotional changes, deterioration of mental faculties and behavioral abnormalities. No sign or symptom of significant increase of intracranial pressure were observed in any case. 4) Ipsilateral cerebral hemiatrophy on the tumor side was evidenced by carotid angiography and by pneumoencephalography. 5) The common site of tumor in this series was the thalamus and its surrounding areas. 6) The tumor was invariably a pinealoma which seemed to be ectopic in every case. 7) The obtained histopathological findings suggest that the ipsilateral cerebral hemiatrophy was due to thinning of the cerebral cortex with degeneration and disappearance of ganglion cells, demyelination in the subcortex and destruction of axons. Our speculated mechanism of ipsilateral cerebral hemiatrophy due to thalamic tumor is that thalamic tumor causes the degeneration and disappearance of thalamic ganglion cells and nerve fibers, consequently occurring secondary Waller's degeneration of afferent and projecting fibers from the thalamus as well as retrograde degeneration of efferent fibers, thus resulting in an extensive atrophy of the cerebral cortex and subcortical tissue.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
17/30. Functions of the centre section (trunk) of the corpus callosum in man.The case is reported of a patient in whom the middle sagittal third of the corpus callosum had been removed for the treatment of an underlying angioma. The special advantages of the case are that the patient is a young, relatively healthy person of normal IQ. The angioma had not interfered with interhemispheric transmission and the patient was described as neurologically normal before operation. After operation left-side neglect and extensive somatic disconnection were seen. A change in the balance between the hemispheres for handedness and ear superiority in dichotic listening was observed. The patient developed an aphasia after operation characterized by a simplification of language, the inavailability of complex ideas and emotional communication. He showed a disorder of memory--'autopragmatic amnesia'--in whice. The patient showed disorders of visuo-spatial transfer. These symptoms are thought to typify a syndrome of the centre trunk region of the corpus callosum, to follow as a direct function of the operation performed upon the callosum, and to illustrate the function of this region of the brain.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
18/30. Using computerized tomography to identify neurologic problems.Computerized tomography (CT) scanning accurately identifies neurologic abnormalities in many elderly patients, often making it possible to differentiate symptomatic neurologic changes of normal aging from treatable pathologic states such as occult masses and cerebral infarction producing much the same symptoms. The scan also singles out patients in whom further diagnostic measures are necessary. The advantages of CT--low morbidity, noninvasiveness, and high sensitivity--far outweigh its limitations. Concomitant cerebral atrophy and metabolic imbalance do not significantly affect diagnostic accuracy. Risks are minimal, related chiefly to contrast allergy, and occasionally to anesthetics for patients who cannot remain motionless during the procedure.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
19/30. Intratumoral hemorrhage after a ventriculoperitoneal shunting procedure.Ventriculoperitoneal shunting has been accepted as a safe and useful preliminary procedure that lowers the mortality and morbidity of definitive surgery for tumors causing obstructive hydrocephalus. We are reporting four patients with intratumoral hemorrhage as a complication of shunting. The hemorrhage was massive and fatal in two patients, one with an unverified pineal tumor and the other with a malignant astrocytoma of the thalamus. The hemorrhage was small and limited in the other two patients, one with a glioblastoma of the thalamus and the other with a cerebellar astrocytoma. On the basis of this experience, we conclude that the possibility of intratumoral hemorrhage should be taken into consideration when planning the preoperative management of obstructive hydrocephalus caused by brain tumors. It is possible that ventricular decompression may result in rapid motion and distortion of the intracranial structures and a sudden imbalance between intracranial and intratumoral pressures, leading to vascular insufficiency, congestion, and then hemorrhage within the tumor.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
20/30. motion sickness: part II--a clinical study based on surgery of cerebral hemisphere lesions.Man has always been intrigued with the localization of function within the brain but has paid insufficient attention to the long and the short association fiber pathways which, when stimulated, may fire distant areas evoking unusual responses. Three cases of intracerebral lesions are presented to demonstrate the significance of these structures. The vestibular symptoms of dizziness may occur from excitation of the temporal operculum. If, added to this symptom, the patient has spatial disorientation, such as feeling upside down, it suggests that the region of the supramarginal gyrus and the angular gyrus are involved. When unformed visual hallucinations (such as flashes of light) or formed hallucinations (such as distorted images) are present the occipital and midtemporal regions of the brain, respectively, are considered to be the sources of such responses. The symptoms described above were reminiscent of those experienced by some of the cosmonauts and astronauts and it called the authors' attention to this "motion sickness in space." The areas from which such responses may be elicited are the temporoparieto-occipital regions, which are nourished by the posterior cerebral artery and its branches. Vascular insufficiency to this area by spasm of the vessel may be responsible for this symptomatology.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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